ACTIVE CARE PHARMACY INC NPI 1477061745

NPI Information

  • NPI: 1477061745
  • Provider Name: ACTIVE CARE PHARMACY INC
  • Classification: Pharmacy - 3336L0003X
  • Specialization: Long Term Care Pharmacy
  • Entity Type: Organization
  • :
  • CLIA Number: 05D2188209
  • Address: 11770 WARNER AVE STE 101
    FOUNTAIN VALLEY, CA
    ZIP 92708
  • Phone: (714) 733-7930

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NPI Details

ACTIVE CARE PHARMACY INC is a long term care pharmacy pharmacy in Fountain Valley, CA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. ACTIVE CARE PHARMACY INC NPI is 1477061745. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

11770 WARNER AVE STE 101
FOUNTAIN VALLEY, CA
ZIP 92708-659
Phone: (714) 733-7930
Fax: (714) 951-9333

The provider's authorized official is Tyrone Nguyen .
The authorized official title is Ceo/owner and has the following contact phone number (714) 733-7930.

The CLIA number assigned to this NPI record is 05D2188209 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Coronavirus vaccine 13 (HCPCS:91312)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 1/19/2018 and was last updated on 11/18/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care Pharmacy55862CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
157681OTHERCALIFORNIAPHARMACY PERMIT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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