Healthcare Provider Details

I. General information

NPI: 1629616784
Provider Name (Legal Business Name): PRECISE CARE SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CHESTNUT AVE
SOUTH SAN FRANCISCO CA
94080-3229
US

IV. Provider business mailing address

26809 SACK CT
SANTA CLARITA CA
91351-6936
US

V. Phone/Fax

Practice location:
  • Phone: 818-294-2657
  • Fax: 661-310-3848
Mailing address:
  • Phone: 818-294-2657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GINGER JOHNSON
Title or Position: MANAGER
Credential:
Phone: 818-294-2657