Bascom Pharmacy LLC
Bascom Pharmacy LLC is a healthcare organization registered as Long Term Care Pharmacy in San Jose, CA, holding Type 2 (organization) NPI 1205719978 since 2025. The authorized official on file is Clive Fuller, Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1205719978 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Bascom Pharmacy LLC |
| Practice address | 105 N BASCOM AVE STE 101, San Jose, CA, 95128 |
| Phone | 4089956020 |
| Fax | 4089955320 |
| Enumeration date | 2025-07-29 |
| Last updated in NPPES | 2025-07-29 |
Authorized official
| Name | Clive Fuller |
|---|---|
| Title | Manager |
| Phone | 5106913371 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336L0003X | Long Term Care Pharmacy | Primary | — | — |
Copy-ready billing details
Provider: Bascom Pharmacy LLC NPI: 1205719978 Taxonomy: 3336L0003X (Long Term Care Pharmacy) Address: 105 N BASCOM AVE STE 101, San Jose, CA, 95128
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1669680997 | Clive Fuller | Individual | Pharmacist | San Jose, CA |
Verify this record
Cross-check NPI 1205719978 against the authoritative CMS record: view Bascom Pharmacy LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Bascom Pharmacy LLC?
Who is the authorized official for Bascom Pharmacy LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2025-07-29.