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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