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Organization
WHITE HOUSE PHARMACY INC
Active
Organization
WHITE HOUSE PHARMACY INC
Active
Other names
SAN JOSE COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK J D'ANGELO (PRESIDENT/OWNER)
(408) 296-5015
Entity
Organization
Contact information
Practice address
2453 FOREST AVE, SAN JOSE, CA 95128-1505
(408) 296-5015
(408) 248-2790
Mailing address
2453 FOREST AVE, SAN JOSE, CA 95128-1505
(408) 296-5015
(408) 248-2790
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY54957
CA
3336C0004X
Compounding Pharmacy
PHY54957
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY 54957
BOARD OF PHARMACY PERMIT
CA
Enumeration date
09/01/2016
Last updated
10/05/2016
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