Wellspring Compounding Pharmacy, Inc

LBN: Valor Compounding Pharmacy, Inc
Wellspring Compounding Pharmacy, Inc is an health care organization with primary practice located at 2461 Shattuck Ave. , Berkeley CA 94704. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty. Valor Compounding Pharmacy, Inc can be contacted via phone (510) 548-8777, or through Niemi, Richard T. via phone (916) 622-0267.

Contact Information

Primary practice address
2461 Shattuck Ave. Berkeley CA 94704
Phone: (510) 548-8777
Fax: (510) 548-0305
Website:
Map and Directions
Authorized official contact:
Name: Niemi, Richard T.
Phone: (916) 622-0267

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Compounding Pharmacy 3336C0004X PHY55419 California

Profile Details

NPI number 1881712701
LBN Legal business name Valor Compounding Pharmacy, Inc
DBA Doing business as Wellspring Compounding Pharmacy, Inc
Authorized official Niemi, Richard T.
Entity Organization
Organization subpart 1 No
Enumeration date Mar 27th, 2007
Last updated Sep 28th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881712701 NPPES
Other 2160470 PK

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