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

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: July 26, 2026.

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
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

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.

Pharmacy (Community/Retail Pharmacy)
4428 GLACIER AVE
SAN DIEGO, CA 92120
Pharmacy (Long Term Care Pharmacy)
4428 GLACIER AVE
SAN DIEGO, CA 92120
Pharmacy (Long Term Care Pharmacy)
4428 GLACIER AVE
SAN DIEGO, CA 92120

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 with the weekly NPPES data releases published by CMS.