Healthcare Provider Details

I. General information

NPI: 1477568095
Provider Name (Legal Business Name): PRECISION PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 YOUNG ST
BAKERSFIELD CA
93311-8978
US

IV. Provider business mailing address

5301 YOUNG ST
BAKERSFIELD CA
93311-8978
US

V. Phone/Fax

Practice location:
  • Phone: 661-377-3333
  • Fax: 661-377-3334
Mailing address:
  • Phone: 661-377-3333
  • Fax: 661-377-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47310
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PATRICK WADE
Title or Position: OWNER
Credential:
Phone: 661-377-3333