# EXTENDED HOME CARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Extended Homecare Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326262551
- **Authorized official:** DR. CHARLES J TIEE PHARM. D. (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (714) 662-5589

## Contact information

- **Practice address:** 3303 HARBOR BLVD, E-6, COSTA MESA, CA 92626-1530
- **Practice address phone:** (714) 668-5589
- **Practice address fax:** (714) 434-1215
- **Mailing address:** PO BOX 73, CORONA DEL MAR, CA 92625-0073
- **Mailing address phone:** (714) 662-5589
- **Mailing address fax:** (714) 454-1215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PHY462120 | CA | Yes |

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PHA462120 | — | CA |