Healthcare Provider Details
I. General information
NPI: 1225636889
Provider Name (Legal Business Name): MED-PLUS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2020
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
335 LINDBERGH AVE
LIVERMORE CA
94551-9291
US
IV. Provider business mailing address
277 E. ROWLAND ST
COVINA CA
91723-3149
US
V. Phone/Fax
- Phone: 888-222-8405
- Fax: 877-363-3757
- Phone: 866-463-3757
- Fax: 626-593-5733
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REGINA
HUNT
Title or Position: CORPORATE DIRECTOR OF COMPLIANCE, C
Credential:
Phone: 800-589-9747