PROVISION PHARMACY, INC.
NPI 1417811647
Pharmacy - Community/Retail Pharmacy in San Diego, CA

Q: What is Provision Pharmacy, Inc.'s NPI number?

The NPI number for Provision Pharmacy, Inc. is 1417811647. It was assigned to this organization in the NPPES registry on December 11, 2025.

Q: What is Provision Pharmacy, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since December 11, 2025

4428 GLACIER AVE, SAN DIEGO, CA 92120(808) 854-8999 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Provision Pharmacy, Inc. NPPES

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

PROVISION PHARMACY, INC. (NPI 1417811647) is a healthcare organization registered as a community/retail pharmacy in San Diego, California and active in the NPI registry since December 2025. The organization lists Alan Chan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1417811647

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NamePROVISION PHARMACY, INC.

Location Address4428 GLACIER AVESan Diego, CA 92120-3304

Mailing Address4428 Glacier AveSan Diego, CA 92120-3304 · (808) 854-8999

Phone(808) 854-8999

Organization SubpartNo

Authorized OfficialAlan ChanCeo · (808) 854-8999

Enumeration DateDecember 11, 2025

NPPES CertifiedDecember 11, 2025

✔ NPI 1417811647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

4428 GLACIER AVE, San Diego, CA 92120

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Other Providers at the Same Location NPPES 3

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

MACTOR, INC.

Pharmacy (Community/Retail Pharmacy)

4428 GLACIER AVE
SAN DIEGO, CA 92120

San Diego County (619) 466-3246

MACTOR, INC.

Pharmacy (Long Term Care Pharmacy)

4428 GLACIER AVE
SAN DIEGO, CA 92120

San Diego County (916) 993-0212

PROVISION PHARMACY, INC. -LTC

Pharmacy (Long Term Care Pharmacy)

4428 GLACIER AVE
SAN DIEGO, CA 92120

San Diego County (808) 854-8999

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 Provision Pharmacy, Inc.'s NPI number?

The NPI number for Provision Pharmacy, Inc. is 1417811647. It was assigned to this organization in the NPPES registry on December 11, 2025.

Where is Provision Pharmacy, Inc. located?

Provision Pharmacy, Inc. is located at 4428 Glacier Ave, San Diego, CA 92120. The listed phone number is (808) 854-8999.

What is Provision Pharmacy, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Provision Pharmacy, Inc. was last updated on December 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.