Organization
INNOVATIVE INTRATHECAL SOLUTIONS INC
Active
Organization
INNOVATIVE INTRATHECAL SOLUTIONS INC
Active
Other names
INNOVATIVE COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY BARRACK RPH (PRESIDENT)
(951) 304-9530
Entity
Organization
Contact information
Practice address
41538 EASTMAN DR, MURRIETA, CA 92562-8007
(951) 304-9530
(951) 304-9540
Mailing address
41538 EASTMAN DR, MURRIETA, CA 92562-8007
(951) 304-9530
(951) 304-9540
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY49935
CA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997382
PK
—
05
—
PHA45898
—
CA
Enumeration date
12/26/2006
Last updated
06/20/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up