MEDICARE: PHARM PLUS ACQUISITION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336H0001X	Home Infusion Therapy Pharmacy	46321	CA
2	333600000X	Pharmacy	46321	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114926961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARM PLUS ACQUISITION INC

Provider Business Mailing Address
First Line	:	5025 PLANO PKWY
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-5022
Country	:	US
Telephone Number	:	469-365-8287
Fax Number	:	844-811-7689

Provider Business Practice Location Address
First Line	:	5100 E HUNTER AVE
Second Line	:	SUITE 101
City	:	ANAHEIM
State	:	CA
Zip	:	92807-2049
Country	:	US
Telephone Number	:	800-801-1140
Fax Number	:	469-365-8274

Authorized Official
Title or Position	:	SR. CONSULTANT PAYER RELATIONS
Name	:	SANDY L CAMPA
Credential	:
Telephone Number	:	909-799-4174

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	10/17/2022

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Directions to “PHARM PLUS ACQUISITION INC ” Practice Location

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