Organization
EXPERT COMPOUNDING PHARMACY INC
Active
Other names
Expert Compounding Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MADIEVSKY (PRESIDENT)
(818) 988-7979
Entity
Organization
Contact information
Practice address
6744 BALBOA BLVD, VAN NUYS, CA 91406-5532
(818) 988-7979
(818) 787-7256
Mailing address
6744 BALBOA BLVD, VAN NUYS, CA 91406-5532
(818) 988-7979
(818) 787-7256
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
50124
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122842
PK
—
Enumeration date
10/05/2005
Last updated
06/02/2016
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