=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437458247
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | U.S. PHARMCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2011
-----------------------------------------------------
Last Update Date | 03/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14623 HAWTHORNE BLVD SUITE 104
-----------------------------------------------------
City | LAWNDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90260-1581
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-877-5013
-----------------------------------------------------
Fax | 213-404-5544
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 416
-----------------------------------------------------
City | LAWNDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90260-0416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-877-5013
-----------------------------------------------------
Fax | 213-404-5544
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | MR. JACOB SHOHAM
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 800-877-5013
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 50454
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 50454
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------