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General NPI Number Information
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NPI Number | 1750415469
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Entity Type | Organization
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Legal Business Name | DAVIS COMPOUNDING SOLUTIONS
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 1205 DRAKE DR STE E
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City | DAVIS
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State | CA
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Zip | 95616-0856
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Country | US
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Telephone | 530-756-1255
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Fax | 530-756-1253
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Provider Business Mailing Address
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Address Line | 1205 DRAKE DR STE E
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City | DAVIS
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State | CA
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Zip | 95616-0856
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Country | US
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Telephone | 530-756-1255
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Fax | 530-756-1253
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES SNIPES JR.
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Credential | R.PH.
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Telephone | 530-756-1255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY45970
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License Number State | CA
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