Proactive Care Pharmacy, LLC.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PROACTIVE CARE PHARMACY, LLC.

Practice address

7345 Linda Vista Rd Ste E
San Diego, CA 92111-5800

Phone

(858) 405-4675

NPI assigned

Mar 31, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Anh Pham, RPHNPI 1902174402

Title

Ceo

Phone

(858) 405-6759

Specialties & licenses 2

Addresses

Other names 2

• Proactive Care Pharmacy Doing business as
• Proactive Care Pharmacy & Medical Supplies Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anh Thu Nu Pham, RPH

  • Pharmacist
  • San Diego, CA
  • NPI 1902174402
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1205464658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11859 TRAIL CREST DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921316147",
            "telephone_number": "858-405-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 LINDA VISTA RD STE E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115800",
            "telephone_number": "858-405-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE CARE PHARMACY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "ANH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-405-6759",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proactive Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive Care Pharmacy & Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Natasha Proa
• Proactive Physical Therapy & Sports Medicine
• Procare Home Health Services Inc
• Procare Pharmacy LLC
• Ann Marie T. Prochera, M.D.
• Andrea Lynn Procko, MS, PHD

• Community/Retail Pharmacy in San Diego, CA
• Providers in San Diego, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.