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MACTOR, INC.
NPI 1801489323
Pharmacy - Long Term Care Pharmacy in San Diego, CA

Active since February 16, 2021
4428 GLACIER AVE, SAN DIEGO, CA 92120(916) 993-0212 Get Directions Write a Review

NPPES record last updated: February 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mactor, Inc. NPPES

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

MACTOR, INC. (NPI 1801489323), doing business as Provision Pharmacy, is a healthcare organization registered as a long term care pharmacy in San Diego, California and active in the NPI registry since February 2021. The organization lists Mitesh Patel, President, as its authorized official.

NPPES Registry Identity

NPI1801489323
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameMACTOR, INC.
Location Address4428 GLACIER AVESan Diego, CA 92120-3304
Mailing Address4428 Glacier AveSan Diego, CA 92120-3304 · (916) 993-0212
Phone(916) 993-0212
Organization SubpartNo
Authorized OfficialMitesh PatelPresident · (619) 269-6600
Enumeration DateFebruary 16, 2021
NPPES CertifiedFebruary 16, 2021
✔ NPI 1801489323 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.
4428 GLACIER AVE, San Diego, CA 92120
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Other Names 1

Doing Business AsProvision Pharmacy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans and more.Insurance ›

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.

PROVISION PHARMACY, INC.
Pharmacy (Community/Retail Pharmacy)
4428 GLACIER AVE
SAN DIEGO, CA 92120
San Diego County (808) 854-8999
MACTOR, INC.
Pharmacy (Community/Retail Pharmacy)
4428 GLACIER AVE
SAN DIEGO, CA 92120
San Diego County (619) 466-3246
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 Mactor, Inc.'s NPI number?

The NPI number for Mactor, Inc. is 1801489323. It was assigned to this organization in the NPPES registry on February 16, 2021. The provider is doing business as Provision Pharmacy.

Where is Mactor, Inc. located?

Mactor, Inc. is located at 4428 Glacier Ave, San Diego, CA 92120. The listed phone number is (916) 993-0212.

What is Mactor, Inc.'s specialty?

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

What insurance does Mactor, Inc. accept?

Health plans from Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans, Baylor Scott and White Health Plan and Blue Cross Blue Shield of North Dakota and 11 other insurers list Mactor, Inc. 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 Mactor, Inc. was last updated on February 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.