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BASCOM PHARMACY LLC
NPI 1205719978
Pharmacy - Long Term Care Pharmacy in San Jose, CA

Active since July 29, 2025
105 N BASCOM AVE STE 101, SAN JOSE, CA 95128(408) 995-6020(408) 995-5320 Get Directions Write a Review

NPPES record last updated: July 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bascom Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BASCOM PHARMACY LLC (NPI 1205719978) is a healthcare organization registered as a long term care pharmacy in San Jose, California and active in the NPI registry since July 2025. The organization lists Clive Fuller, Manager, as its authorized official.

NPPES Registry Identity

NPI1205719978
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameBASCOM PHARMACY LLC
Location Address105 N BASCOM AVE STE 101San Jose, CA 95128-1811
Mailing Address105 N Bascom Ave Ste 101San Jose, CA 95128-1811 · (408) 995-6020 · Fax (408) 995-5320
Phone(408) 995-6020
Fax(408) 995-5320
Organization SubpartNo
Authorized OfficialClive FullerManager · (510) 691-3371
Enumeration DateJuly 29, 2025
NPPES CertifiedJuly 29, 2025
✔ NPI 1205719978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
105 N BASCOM AVE STE 101, San Jose, CA 95128
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CLIVE FULLER PHARMD
Pharmacist
105 N BASCOM AVE STE 101
SAN JOSE, CA 95128
Santa Clara County (408) 995-6020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bascom Pharmacy LLC's NPI number?

The NPI number for Bascom Pharmacy LLC is 1205719978. It was assigned to this organization in the NPPES registry on July 29, 2025.

Where is Bascom Pharmacy LLC located?

Bascom Pharmacy LLC is located at 105 N Bascom Ave Ste 101, San Jose, CA 95128. The listed phone number is (408) 995-6020.

What is Bascom Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

When was this NPI record last updated?

The NPPES record for Bascom Pharmacy LLC was last updated on July 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.