Organization
RECOMBI INC
Active
Other names
RECOMBIRX
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY PARK PHARMD (PHARMACIST PRESIDENT CEO)
(805) 208-4140
Entity
Organization
Contact information
Practice address
250 N WESTLAKE BLVD, STE 250, WESTLAKE VILLAGE, CA 91362-3700
(805) 496-4202
(866) 222-6636
Mailing address
250 N WESTLAKE BLVD, STE 250, WESTLAKE VILLAGE, CA 91362-3700
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
48231
CA
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5624590
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA482310
—
CA
Enumeration date
11/17/2006
Last updated
08/14/2007
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