Organization
VINTAGE COMPOUNDING PHARMACY LLC
Active
Other names
Vintage Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD ZAMANIAN (PHARM.D, RPH)
(505) 620-4352
Entity
Organization
Contact information
Practice address
9821 MONTGOMERY BLVD NE STE A, ALBUQUERQUE, NM 87111-3571
(505) 620-4352
Mailing address
9821 MONTGOMERY BLVD NE STE A, ALBUQUERQUE, NM 87111-3571
(505) 620-4352
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
07/20/2023
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