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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