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PROVISION PHARMACY, INC. -LTC
NPI 1962366195
Pharmacy - Long Term Care 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: August 02, 2026.

About Provision Pharmacy, Inc. -ltc NPPES

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

PROVISION PHARMACY, INC. -LTC (NPI 1962366195) is a healthcare organization registered as a long term care 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

NPI1962366195
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NamePROVISION PHARMACY, INC. -LTC
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 1962366195 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 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
MACTOR, INC.
Pharmacy (Long Term Care Pharmacy)
4428 GLACIER AVE
SAN DIEGO, CA 92120
San Diego County (916) 993-0212

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. -Ltc's NPI number?

The NPI number for Provision Pharmacy, Inc. -Ltc is 1962366195. It was assigned to this organization in the NPPES registry on December 11, 2025.

Where is Provision Pharmacy, Inc. -Ltc located?

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

What is Provision Pharmacy, Inc. -Ltc'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 Provision Pharmacy, Inc. -Ltc 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 7 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.