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Organization
ALCOSTA PHARMACY ASSOCIATES INC
Active
Organization
ALCOSTA PHARMACY ASSOCIATES INC
Active
Other names
Custom Care Compounding
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KAY CLAUSER (TREASUER)
(925) 830-0581
Entity
Organization
Contact information
Practice address
124 MARKET PL, SAN RAMON, CA 94583-4740
(925) 830-4631
(925) 830-0125
Mailing address
124 MARKET PL, SAN RAMON, CA 94583-4740
(925) 830-4631
(925) 830-0125
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHY41451
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2036044
PK
—
05
—
PHA414510
—
CA
Enumeration date
08/10/2006
Last updated
07/19/2018
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