Organization
PRAMUKH HEALTHCARE LLC
Active
Other names
Blossom Hill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA SCOTT (DELEGATED OFFICIAL,AO)
(832) 646-5119
Entity
Organization
Contact information
Practice address
393 BLOSSOM HILL RD STE 101, SAN JOSE, CA 95123-1653
(408) 224-8192
(408) 224-8173
Mailing address
PO BOX 1047, RICHMOND, TX 77406-0027
(281) 232-3940
(832) 595-1203
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
52488
CA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151607
PK
—
Enumeration date
08/17/2012
Last updated
10/05/2016
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