# ACTIVE CARE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ACTIVE CARE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477061745
- **Authorized official:** TYRONE NGUYEN (CEO/OWNER)
- **Authorized official phone:** (714) 733-7930

## Contact information

- **Practice address:** 11770 WARNER AVE STE 101, FOUNTAIN VALLEY, CA 92708-2659
- **Practice address phone:** (714) 733-7930
- **Practice address fax:** (714) 951-9333
- **Mailing address:** 11770 WARNER AVE STE 101, FOUNTAIN VALLEY, CA 92708-2659
- **Mailing address phone:** (714) 733-7930
- **Mailing address fax:** (714) 951-9333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 55862 | CA | Yes |

## Other

- **Enumeration date:** 01/19/2018
- **Last updated:** 11/18/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 57681 | PHARMACY PERMIT | CA |