Provider Demographics
NPI:1609209352
Name:SANTA BARBARA SPECIALTY PHARMACY LLC
Entity Type:Organization
Organization Name:SANTA BARBARA SPECIALTY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-292-0744
Mailing Address - Street 1:376 NORTHLAKE BLVD STE 1008
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5261
Mailing Address - Country:US
Mailing Address - Phone:888-292-0744
Mailing Address - Fax:833-670-2942
Practice Address - Street 1:4690 CARPINTERIA AVE STE B
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-1875
Practice Address - Country:US
Practice Address - Phone:805-770-2061
Practice Address - Fax:805-456-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55695333600000X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY58666OtherPHARMACY LICENSE