Healthcare Provider Details

I. General information

NPI: 1104380252
Provider Name (Legal Business Name): AHCS SPECIALTY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 TRIBUTE RD STE G
SACRAMENTO CA
95815-4307
US

IV. Provider business mailing address

1820 TRIBUTE RD STE G
SACRAMENTO CA
95815-4307
US

V. Phone/Fax

Practice location:
  • Phone: 916-518-0659
  • Fax: 916-665-4205
Mailing address:
  • Phone: 916-518-0659
  • Fax: 916-665-4205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NEVIL JHAVERI
Title or Position: OWNER
Credential:
Phone: 916-518-0659