MEDICARE: UNITED CARE PHARMACY , LLC

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	333600000X	Pharmacy	PHY49087	CA
2	3336L0003X	Long Term Care Pharmacy	PHY49087	CA

General Provider Information

NPI Number	:	1396740494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED CARE PHARMACY , LLC

Provider Business Mailing Address
First Line	:	2700 INTERNATIONAL BLVD
Second Line	:	# A
City	:	OAKLAND
State	:	CA
Zip	:	94601-1520
Country	:	US
Telephone Number	:	510-532-1762
Fax Number	:	510-536-2016

Provider Business Practice Location Address
First Line	:	2700 INTERNATIONAL BLVD
Second Line	:	# A
City	:	OAKLAND
State	:	CA
Zip	:	94601-1520
Country	:	US
Telephone Number	:	510-532-1762
Fax Number	:	510-536-2016

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HOLLY JOHNSON FRIAR
Credential	:
Telephone Number	:	510-532-1762

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	10/06/2008

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Directions to “UNITED CARE PHARMACY , LLC ” Practice Location

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