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INNOVATIVE INTRATHECAL SOLUTIONS INC NPI 1093870412


NPI Information

NPI: 1093870412
Provider Name: INNOVATIVE INTRATHECAL SOLUTIONS INC

Doing Business As: INNOVATIVE COMPOUNDING PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
41538 EASTMAN DR
MURRIETA, CA
ZIP 92562
Phone: (951) 304-9530
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INNOVATIVE INTRATHECAL SOLUTIONS INC is a community/retail pharmacy pharmacy in Murrieta, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. INNOVATIVE INTRATHECAL SOLUTIONS INC NPI is 1093870412. The provider is registered as an organization entity type.
The provider Is Doing Business As Innovative Compounding Pharmacy.

The provider's business location address is:

41538 EASTMAN DR
MURRIETA, CA
ZIP 92562-007
Phone: (951) 304-9530
Fax: (951) 304-9540

The provider's authorized official is Anthony Barrack .
The authorized official title is President and has the following contact phone number (951) 304-9530.

The enumeration date for this NPI number is 12/26/2006 and was last updated on 6/20/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0004XPharmacyCompounding PharmacyNo
33336S0011XPharmacySpecialty PharmacyNo
43336C0003XPharmacyCommunity/Retail PharmacyPHY49935CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PHA45898MEDICAIDCALIFORNIA
21997382OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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