MEDICARE: ALTO PHARMACY, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3336S0011X	Specialty Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHY57953	OTHER	CA	PHARMACY PERMIT
2	5673947	OTHER		NCPDP

General Provider Information

NPI Number	:	1235736737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTO PHARMACY, LLC

Provider Business Mailing Address
First Line	:	645 HARRISON ST STE 200
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94107-3624
Country	:	US
Telephone Number	:	800-874-5881
Fax Number	:	415-484-7058

Provider Business Practice Location Address
First Line	:	2360 QUME DR STE A
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95131-1838
Country	:	US
Telephone Number	:	800-874-5881
Fax Number	:	415-484-7058

Authorized Official
Title or Position	:	SR. MANAGER OF OPERATIONS
Name	:	LAUREN HAMMOND
Credential	:
Telephone Number	:	800-874-5881

Provider Enumeration Date	:	10/07/2020
Last Update Date	:	10/26/2023

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Directions to “ALTO PHARMACY, LLC ” Practice Location

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