Organization
COMPOUNDIA PHARMACY INC
Active
Other names
Compoundia Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY VISO (OWNER)
(855) 371-4443
Entity
Organization
Contact information
Practice address
766 LAKEFIELD RD STE E, WESTLAKE VILLAGE, CA 91361-2661
(855) 371-4443
(805) 371-4375
Mailing address
1014 S WESTLAKE BLVD STE 14-291, WESTLAKE VILLAGE, CA 91361-3108
(855) 371-4443
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
50901
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134920
PK
—
Enumeration date
04/24/2012
Last updated
07/01/2016
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