Bascom Pharmacy Llc
Community/Retail Pharmacy
105 N Bascom Ave, Ste 101, San Jose
California, 95128-1811
408-995-6020 408-995-5320
Bascom Pharmacy Llc is a Community/Retail Pharmacy in San Jose, California. It is located at 105 N Bascom Ave, Ste 101, San Jose and it's customer support contact number is 408-995-6020. The authorized person of Bascom Pharmacy Llc is Clive Fuller, PHARMD who is Manager of the pharmacy and his contact number is 408-995-6020. Active license number of Bascom Pharmacy Llc is 47147 for Community/Retail Pharmacy in California. Bascom Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Bascom Pharmacy Llc is 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.
Pharmacy Details:
Bascom Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Bascom Pharmacy Llc |
| Type: | Community/Retail Pharmacy |
| Location: | 105 N Bascom Ave, Ste 101, San Jose,
California, 95128-1811 |
| Phone: | 408-995-6020 |
| Fax: | 408-995-5320 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Clive Fuller |
| Credentials: | PHARMD |
| Position: | Manager |
| Contact Number: | 408-995-6020 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1457463374 |
| NPI Enumeration Date: | 31 Aug, 2006 |
| NPI Last Update On: | 29 Jul, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Bascom Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 47147 | California | Primary | |
| Specialty Pharmacy | | | Secondary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| PHA471470 | Medicaid | California | |
| 2113723 | Other | | Pk |
| 5993930001 | Medicaid | California | |
Medicare Enrollment:
Bascom Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 4880895465 | O20100930024902 | Bascom Pharmacy Llc | DME SUPPLIER - PHARMACY |
Products Available:
Bascom Pharmacy Llc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Heat & Cold Applications | • Nebulizer Equipment & Supplies |
| • Orthoses: Off-the-shelf | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 105 N Bascom Ave, Ste 101
San Jose, California |
| Zip: | 95128-1811 |
| Phone Number: | 408-995-6020 |
| Fax Number: | 408-995-5320 |
Patients can reach Bascom Pharmacy Llc at
105 N Bascom Ave, Ste 101, San Jose, California or can
call on customer care at 408-995-6020.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.