1. Home
  2. Directory
  3. California
  4. San Jose
  5. Pharmacy
  6. NPI Profile

BASCOM PHARMACY LLC
NPI 1457463374
Pharmacy - Community/Retail Pharmacy in San Jose, CA

Active since August 31, 2006
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.

Record update history: Apr 11, 2017, Mar 29, 2016 (2 updates tracked since 2016).

About Bascom Pharmacy Llc NPPES

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

BASCOM PHARMACY LLC (NPI 1457463374), doing business as Bascom Pharmacy, is a healthcare organization registered as a community/retail pharmacy in San Jose, California and active in the NPI registry since August 2006. The organization lists Clive Fuller, Manager, as its authorized official.

NPPES Registry Identity

NPI1457463374
Entity TypeOrganization
Primary Taxonomy3336C0003X
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 · (408) 995-6020
Enumeration DateAugust 31, 2006
Last NPPES UpdateJuly 29, 20252 updates tracked since enumeration
NPPES CertifiedJuly 29, 2025
✔ NPI 1457463374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · 47147
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.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
105 N BASCOM AVE, San Jose, CA 95128
Open in Google Maps ↗

Other Names 1

Doing Business AsBascom Pharmacy

Other Identifiers 3

MedicaidPHA471470CA
Other2113723Pk
Medicaid5993930001CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Avera Health Plans, Baylor Scott and White Health Plan and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Bascom Pharmacy LLC carries, from the Medicare DMEPOS supplier directory.

Bascom Pharmacy LLC

DMEPOS supplier · San Jose, CA
⋮

Does not accept Medicare assignment

Bascom Pharmacy LLC has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20576387
Medicare Participant SinceDecember 19, 2005
Supplier Location105 N Bascom Ave Ste 101San Jose, CA 95128
Phone(408) 995-6020
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

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

INTERVENTIONAL RADIOLOGY COVERAGE INC
Specialist
105 N BASCOM AVE, SUITE 104
SAN JOSE, CA 95128
Santa Clara County (408) 918-0405
SOUTH BAY CARDIOVASCULAR MEDICAL GROUP, INC
Specialist
105 N BASCOM AVE, SUITE 204
SAN JOSE, CA 95128
Santa Clara County (408) 918-0400
DR. ALEXANDER D DOAN MD
Internal Medicine (Nephrology)
105 N BASCOM AVE, #103
SAN JOSE, CA 95128
Santa Clara County (408) 998-2890
INTERVENTIONAL VASCULAR INSTITUTE OF SAN JOSE, LLC
Radiology (Vascular & Interventional Radiology)
105 N BASCOM AVE
SAN JOSE, CA 95128
Santa Clara County (408) 918-0405
VISAKHA GOONEWARDENA M.D
Internal Medicine
105 N BASCOM AVE, SUITE 202
SAN JOSE, CA 95128
Santa Clara County (408) 993-1500
JOCELYN THUY ANH NGUYEN DO
Family Medicine
105 N BASCOM AVE
SAN JOSE, CA 95128
Santa Clara County (408) 780-4667
DR. ARASH M PADIDAR MD
Radiology (Vascular & Interventional Radiology)
105 N BASCOM AVE, STE 104
SAN JOSE, CA 95128
Santa Clara County (408) 918-0405
IR SOLUTIONS INC MEDICAL CORP
Radiology (Vascular & Interventional Radiology)
105 N BASCOM AVE, SUITE 104
SAN JOSE, CA 95128
Santa Clara County (408) 418-2151

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 1457463374. It was assigned to this organization in the NPPES registry on August 31, 2006. The provider is doing business as Bascom Pharmacy.

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 Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Bascom Pharmacy LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Bascom Pharmacy LLC does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Bascom Pharmacy LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Avera Health Plans, Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Kansas City and BlueCross BlueShield of Tennessee and 11 other insurers list Bascom Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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.