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Organization
PERSONS COMPOUNDING PHARMACY, INC.
Active
Organization
PERSONS COMPOUNDING PHARMACY, INC.
Active
Other names
PERSONS COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NADIA SIMANTOV PHARMACIST (CFO PIC)
(818) 243-3144
Entity
Organization
Contact information
Practice address
812 N GLENDALE AVE, GLENDALE, CA 91206
(818) 243-3144
(818) 243-2171
Mailing address
812 N GLENDALE AVE, GLENDALE, CA 91206
(818) 243-3144
(818) 243-2171
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHY57442
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0523983
NCPDP
—
05
—
PHY154930
—
CA
Enumeration date
02/22/2007
Last updated
08/22/2020
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