Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
TULLY CLINIC PHARMACY
Active
Organization
TULLY CLINIC PHARMACY
Active
Other names
TULLY MEDICAL CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAI VO (PIC AND PRESIDENT)
(408) 274-6698
Entity
Organization
Contact information
Practice address
1693 FLANIGAN DR, STE 104, SAN JOSE, CA 95121-1683
(408) 274-6698
(408) 274-8580
Mailing address
1693 FLANIGAN DR, STE 104, SAN JOSE, CA 95121-1683
(408) 274-6698
(408) 274-8580
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY35754
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0598536
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA357540
—
CA
Enumeration date
02/27/2007
Last updated
11/15/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up