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General NPI Number Information
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NPI Number | 1992915888
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Entity Type | Organization
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Legal Business Name | VALLEY DRUG AND COMPOUNDING
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16928 VENTURA BLVD
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City | ENCINO
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State | CA
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Zip | 91316-4124
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Country | US
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Telephone | 818-788-0635
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Fax | 818-386-2688
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Provider Business Mailing Address
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Address Line | 16928 VENTURA BLVD
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City | ENCINO
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State | CA
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Zip | 91316-4124
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Country | US
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Telephone | 818-788-0635
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Fax | 818-386-2688
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. IRVING REITZENSTEIN
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Credential | PHARM.D.
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Telephone | 818-788-0635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY43557
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License Number State | CA
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