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General NPI Number Information
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NPI Number | 1770926610
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Entity Type | Organization
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Legal Business Name | VIP COMPOUNDING PHARMACY CORP
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 23206 LYONS AVE STE 112
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City | NEWHALL
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State | CA
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Zip | 91321-2667
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Country | US
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Telephone | 661-777-7770
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Fax | 661-777-7776
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Provider Business Mailing Address
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Address Line | 23206 LYONS AVE STE 112
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City | NEWHALL
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State | CA
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Zip | 91321-2667
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Country | US
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Telephone | 661-777-7770
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Fax | 661-777-7776
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Authorized Official
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Title or Position | PRESIDENT/PIC
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Name | DR. POUYA FARZADFAR
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Credential | PHARM D
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Telephone | 661-777-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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