Organization
VALLEY COMPOUNDING PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONTE LEVAQUE (RPH/MEMBER)
(360) 419-0928
Entity
Organization
Contact information
Practice address
221 S 1ST ST, MOUNT VERNON, WA 98273-3802
(360) 419-0928
(360) 419-0929
Mailing address
221 S 1ST ST, MOUNT VERNON, WA 98273-3802
(360) 419-0928
(360) 419-0929
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHAR.CF.60274451
WA
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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