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
Fax: (779) 545-2277
Website:
Authorized official contact:
Name: Lehan, Jonathan M PHARMD

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376802462 NPPES
Other 2135285 PK
MEDICAID 362674647002 PK

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