Bascom Pharmacy LLC
NPI 1457463374 · Community/Retail Pharmacy · San Jose, CA
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Bascom Pharmacy LLC is a Community/Retail Pharmacy organization in San Jose, CA (NPI 1457463374).
Provider details
- NPI number
- 1457463374
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Clive Fuller, Manager(408) 995-6020
Specialties & taxonomies
Suppliers
- Specialty Pharmacy3336S0011X
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Bascom Pharmacy
Registry dates
- Enumerated
- 2006-08-31
- Last updated
- 2025-07-29
- Certified
- 2025-07-29
Frequently asked questions
- What is Bascom Pharmacy LLC's NPI number?
- Bascom Pharmacy LLC's National Provider Identifier (NPI) is 1457463374, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bascom Pharmacy LLC?
- Bascom Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Bascom Pharmacy LLC located?
- Bascom Pharmacy LLC's practice location on file with NPPES is 105 N Bascom Ave, San Jose, CA 95128-1811.
- What is Bascom Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Bascom Pharmacy LLC is (408) 995-6020.
- Does Bascom Pharmacy LLC accept Medicare?
- Bascom Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Bascom Pharmacy LLC?
- The authorized official listed on Bascom Pharmacy LLC's NPPES record is Clive Fuller, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bascom Pharmacy LLC's NPI active?
- Yes — Bascom Pharmacy LLC's NPI (1457463374) is active in the NPPES registry as of the last update on 2025-07-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.