Organization
ROSS VALLEY COMPOUNDING PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL W LOFHOLM PHARMD (PRESIDENT)
(415) 924-2480
Entity
Organization
Contact information
Practice address
1525 FRANCISCO BLVD E, STE 1, SAN RAFAEL, CA 94901-5539
(415) 924-2480
(415) 924-1015
Mailing address
1525 FRANCISCO BLVD E, STE 1, SAN RAFAEL, CA 94901-5539
(415) 924-2480
(415) 924-1015
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY52077
CA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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