Organization
NUTRISHARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN PULSIPHER (PRESIDENT)
(916) 478-7811
Entity
Organization
Contact information
Practice address
9850 KENT ST, ELK GROVE, CA 95624-9483
(916) 685-5034
Mailing address
9850 KENT ST, ELK GROVE, CA 95624-9483
(916) 685-5034
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHA442630
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0534126
NCPDP
—
01
—
LSC101704
PHARMACY (STERILE)
CA
05
—
PHA442630
—
CA
01
—
PHY58256
PHARMACY
CA
Enumeration date
08/24/2006
Last updated
01/19/2023
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