ACTIVE CARE PHARMACY INC NPI 1477061745

NPI Information

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 Is Doing Business As Active Care Pharmacy.

The provider's business location address is:

17050 BUSHARD ST STE 300
FOUNTAIN VALLEY, CA
ZIP 92708-832
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 enumeration date for this NPI number is 1/19/2018 and was last updated on 4/21/2020.

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:

Other Identifiers

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

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