Organization
PARK COMPOUNDING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW BOLL (SECRETARY & CFO)
(858) 704-4040
Entity
Organization
Contact information
Practice address
9257 RESEARCH DR, IRVINE, CA 92618
(844) 446-6979
(949) 551-1950
Mailing address
12264 EL CAMINO REAL STE 350, SAN DIEGO, CA 92130-0001
(858) 704-4040
(858) 345-1745
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY53360
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0522967
NCPDP
CA
Enumeration date
02/16/2007
Last updated
10/01/2018
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