Provider Demographics
NPI:1851470702
Name:AMERICARE PHARMACY
Entity Type:Organization
Organization Name:AMERICARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:Q
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:916-372-8886
Mailing Address - Street 1:2101 STONE BLVD # 100
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-4044
Mailing Address - Country:US
Mailing Address - Phone:916-372-8886
Mailing Address - Fax:916-372-8885
Practice Address - Street 1:2101 STONE BLVD # 100
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-4044
Practice Address - Country:US
Practice Address - Phone:916-372-8886
Practice Address - Fax:916-372-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAH 145299332B00000X
CAPHY 469743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA46974Medicaid
CAPHA46974Medicaid