Healthcare Provider Details

I. General information

NPI: 1659612885
Provider Name (Legal Business Name): LIFECARE SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 N DAISY AVE
PASADENA CA
91107
US

IV. Provider business mailing address

PO BOX 40700
MESA AZ
85274-0700
US

V. Phone/Fax

Practice location:
  • Phone: 626-683-5401
  • Fax: 626-683-5428
Mailing address:
  • Phone: 480-446-9010
  • Fax: 480-446-7695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY50552
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY50552
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPHY50552
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHY50552
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberPHY50552
License Number StateCA

VIII. Authorized Official

Name: WILLIAM KEYS
Title or Position: CEO
Credential:
Phone: 480-446-9010