Provider Demographics
NPI:1710388384
Name:PHARMACY CARE PROVIDER LLC
Entity Type:Organization
Organization Name:PHARMACY CARE PROVIDER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:520-906-8978
Mailing Address - Street 1:969 N JONES BLVD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4204
Mailing Address - Country:US
Mailing Address - Phone:520-906-8978
Mailing Address - Fax:520-844-8216
Practice Address - Street 1:1135 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5009
Practice Address - Country:US
Practice Address - Phone:520-906-8978
Practice Address - Fax:520-844-8216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY0059813336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy