Organization
INNOVATIVE COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNA RASHIDI PHARMD (OWNERPHARMACIST)
(916) 984-9222
Entity
Organization
Contact information
Practice address
820 WALES DR, SUITE 3, FOLSOM, CA 95630-5546
(916) 984-9222
(916) 458-8267
Mailing address
820 WALES DR, SUITE 3, FOLSOM, CA 95630-5546
(916) 984-9222
(916) 458-8267
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY 48417
CA
Other
Enumeration date
05/11/2007
Last updated
08/03/2007
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