Provider Demographics
NPI:1790094837
Name:PHARMACY CARE USA OF SAN MARCOS, LLC
Entity Type:Organization
Organization Name:PHARMACY CARE USA OF SAN MARCOS, LLC
Other - Org Name:PHARMACY CARE USA OF SAN MARCOS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARNEY
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:ABBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:866-403-2003
Mailing Address - Street 1:PO BOX 431
Mailing Address - Street 2:
Mailing Address - City:HYDRO
Mailing Address - State:OK
Mailing Address - Zip Code:73048-0431
Mailing Address - Country:US
Mailing Address - Phone:512-392-5790
Mailing Address - Fax:855-937-0812
Practice Address - Street 1:320 BARNES DR STE 102
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-6291
Practice Address - Country:US
Practice Address - Phone:512-392-5790
Practice Address - Fax:855-937-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X, 3336S0011X
TX271613336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5901334OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6493150001Medicare NSC