Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bascom Pharmacy LLC

Organization Pharmacy · NPI 1457463374

Bascom Pharmacy LLC is a Pharmacy in San Jose, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

105 N Bascom Ave Ste 101
San Jose, CA 95128-1811
Phone: (408) 995-6020
Fax: (408) 995-5320
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 47147 (CA)
Pharmacy Taxonomy 333600000X
Specialty Pharmacy Taxonomy 3336S0011X

Record details

NPI number1457463374
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clive Fuller — Manager · (408) 995-6020
Other names Bascom Pharmacy
NPI enumeratedAugust 31, 2006
Last updated in NPPESJuly 29, 2025
Certification dateJuly 29, 2025
Mailing address105 N Bascom Ave, Ste 101, San Jose, CA 95128-1811

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