Southern California Compounding Pharmacy

LBN: Southern California Compounding Pharmacy
Southern California Compounding Pharmacy is an health care organization with primary practice located at 11125 Flintkote Ave Ste F , San Diego CA 92121-1213. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Mail Order Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty. Southern California Compounding Pharmacy can be contacted via phone (858) 622-1278, or through Williams, Ollen via phone (858) 622-1278.

Contact Information

Primary practice address
11125 Flintkote Ave Ste F San Diego CA 92121-1213
Phone: (858) 622-1278
Fax: (858) 622-1283
Website:
Map and Directions
Authorized official contact:
Name: Williams, Ollen
Phone: (858) 622-1278

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X PHY49147 California
Suppliers / Mail Order Pharmacy 3336M0002X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1669617734
LBN Legal business name Southern California Compounding Pharmacy
DBA Doing business as Southern California Compounding Pharmacy
Authorized official Williams, Ollen
Entity Organization
Organization subpart 1 No
Enumeration date Dec 3rd, 2008
Last updated Oct 23rd, 2015 - about 11 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 1669617734 NPPES
Other 2117954 PK

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