Innovative Compounding Pharmacy
LBN: Innovative Intrathecal Solutions Inc
Innovative Compounding Pharmacy is an health care organization with primary practice located at 41538 Eastman Dr , Murrieta CA 92562-8007. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Innovative Intrathecal Solutions Inc can be contacted via phone (951) 304-9530, or through Barrack, Anthony via phone (951) 304-9530.
Contact Information
Primary practice address
41538 Eastman Dr
Murrieta CA 92562-8007
Phone: (951) 304-9530
Fax: (951) 304-9540
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY49935 | California |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1093870412 |
|---|---|
| LBN Legal business name | Innovative Intrathecal Solutions Inc |
| DBA Doing business as | Innovative Compounding Pharmacy |
| Authorized official | Barrack, Anthony RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Jun 20th, 2016 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093870412 | NPPES |
| Other | 1997382 | PK | |
| MEDICAID | PHA45898 | PK |
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