Rock Valley Compounding Pharmacy Llc
LBN: Rock Valley Compounding Pharmacy Llc
Rock Valley Compounding Pharmacy Llc is an health care organization with primary practice located at 811 S Perryville Rd Unit 109 , Rockford IL 61108-4323. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty.
Rock Valley Compounding Pharmacy Llc can be contacted via phone (779) 423-0542, or through Lehan, Jonathan M via phone (779) 423-0542.
Contact Information
Primary practice address
811 S Perryville Rd Unit 109
Rockford IL 61108-4323
Phone: (779) 423-0542
Fax: (779) 545-2277
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 054018235 | Illinois |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1376802462 |
|---|---|
| LBN Legal business name | Rock Valley Compounding Pharmacy Llc |
| DBA Doing business as | Rock Valley Compounding Pharmacy Llc |
| Authorized official | Lehan, Jonathan M PHARMD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 9th, 2012 |
| Last updated | Aug 4th, 2022 - about 4 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 | 1376802462 | NPPES |
| Other | 2135285 | PK | |
| MEDICAID | 362674647002 | PK |
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