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NPI Code Detail

MEDICARE: PRAMUKH HEALTHCARE LLC

MEDICARE: PRAMUKH HEALTHCARE 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
13336C0004XCompounding Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
33336L0003XLong Term Care Pharmacy
43336C0003XCommunity/Retail Pharmacy52488CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12151607OTHERPK

General Provider Information

NPI Number : 1750639035
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRAMUKH HEALTHCARE LLC
Provider Business Mailing Address
First Line : PO BOX 1047
Second Line :
City : RICHMOND
State : TX
Zip : 77406-0027
Country : US
Telephone Number : 281-232-3940
Fax Number : 832-595-1203
Provider Business Practice Location Address
First Line : 393 BLOSSOM HILL RD STE 101
Second Line :
City : SAN JOSE
State : CA
Zip : 95123-1653
Country : US
Telephone Number : 408-224-8192
Fax Number : 408-224-8173
Authorized Official
Title or Position : DELEGATED OFFICIAL,AO
Name : SANDRA SCOTT
Credential :
Telephone Number : 832-646-5119
Provider Enumeration Date : 08/17/2012
Last Update Date : 10/05/2016

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Directions to “PRAMUKH HEALTHCARE LLC ” Practice Location

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