Healthcare Provider Details

I. General information

NPI: 1609209352
Provider Name (Legal Business Name): SANTA BARBARA SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4690 CARPINTERIA AVE STE B
CARPINTERIA CA
93013-1875
US

IV. Provider business mailing address

376 NORTHLAKE BLVD STE 1008
ALTAMONTE SPRINGS FL
32701-5261
US

V. Phone/Fax

Practice location:
  • Phone: 805-770-2061
  • Fax: 805-456-0416
Mailing address:
  • Phone: 888-292-0744
  • Fax: 833-670-2942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number55695
License Number StateCA

VIII. Authorized Official

Name: ELVIN MONTANEZ
Title or Position: COO
Credential:
Phone: 888-292-0744