Organization
SAN DIEGO COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME ALAN GREENE RPH FACA (PHARMACIST OWNER)
(858) 277-8884
Entity
Organization
Contact information
Practice address
5395 RUFFIN ROAD, #104, SAN DIEGO, CA 92123
(858) 277-8884
(858) 277-8889
Mailing address
5395 RUFFIN ROAD, #104, SAN DIEGO, CA 92123
(858) 277-8884
(858) 277-8889
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY99276
CA
Other
Enumeration date
12/01/2006
Last updated
08/22/2020
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