Organization
PACIFIC COMPOUNDING PHARMACY AND CONSULTATIONS, INC.
Active
Organization
PACIFIC COMPOUNDING PHARMACY AND CONSULTATIONS, INC.
Active
Other names
PACIFIC COMPUNDING PHARMACY AND CONSULTATIONS
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE COTTMAN PHARM D (PRESIDENT)
(209) 474-7271
Entity
Organization
Contact information
Practice address
312 LINCOLN CTR, STOCKTON, CA 95207-2627
(209) 474-7271
(209) 474-7168
Mailing address
312 LINCOLN CTR, NO SUITE NUMBER, STOCKTON, CA 95207-2627
(209) 474-7271
(209) 474-7168
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47493
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115225
PK
—
Enumeration date
11/03/2006
Last updated
01/23/2017
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