Provider Demographics
NPI:1396740494
Name:UNITED CARE PHARMACY , LLC
Entity type:Organization
Organization Name:UNITED CARE PHARMACY , LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:FRIAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-532-1762
Mailing Address - Street 1:2700 INTERNATIONAL BLVD
Mailing Address - Street 2:# A
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1520
Mailing Address - Country:US
Mailing Address - Phone:510-532-1762
Mailing Address - Fax:510-536-2016
Practice Address - Street 1:2700 INTERNATIONAL BLVD
Practice Address - Street 2:# A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1520
Practice Address - Country:US
Practice Address - Phone:510-532-1762
Practice Address - Fax:510-536-2016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY49087333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy