Organization
PREFERRED COMPOUNDING PHARMACY INC
Active
Organization
PREFERRED COMPOUNDING PHARMACY INC
Active
Other names
Preferred Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TREPHENE BROWN (OWNER)
(818) 360-5004
Entity
Organization
Contact information
Practice address
17547 CHATSWORTH ST, GRANADA HILLS, CA 91344-5720
(818) 360-5004
(818) 360-5004
Mailing address
17547 CHATSWORTH ST, GRANADA HILLS, CA 91344-5720
(818) 360-5004
(818) 360-5005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
54528
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126588
PK
—
Enumeration date
03/23/2010
Last updated
09/22/2016
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