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Organization
EXPERT COMPOUNDING PHARMACY INC
Active
Organization
EXPERT COMPOUNDING PHARMACY INC
Active
Other names
Expert Compounding Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MADIEVSKY (PRESIDENT)
(818) 988-7979
Entity
Organization
Contact information
Practice address
6744 BALBOA BLVD, VAN NUYS, CA 91406-5532
(818) 988-7979
(818) 787-7256
Mailing address
6744 BALBOA BLVD, VAN NUYS, CA 91406-5532
(818) 988-7979
(818) 787-7256
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
50124
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122842
PK
—
Enumeration date
10/05/2005
Last updated
06/02/2016
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