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VALOR COMPOUNDING PHARMACY INC NPI 1881712701


NPI Information

NPI: 1881712701
Provider Name: VALOR COMPOUNDING PHARMACY, INC

Former Legal Business Name: WELLSPRING COMPOUNDING PHARMACY, INC

Classification: Pharmacy - 3336C0004X
Entity Type: Organization

Specialization: Compounding Pharmacy

Address:
2461 SHATTUCK AVE.
BERKELEY, CA
ZIP 94704
Phone: (510) 548-8777
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VALOR COMPOUNDING PHARMACY, INC is a compounding pharmacy pharmacy in Berkeley, CA. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. VALOR COMPOUNDING PHARMACY, INC NPI is 1881712701. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Wellspring Compounding Pharmacy, Inc.

The provider's business location address is:

2461 SHATTUCK AVE.
BERKELEY, CA
ZIP 94704
Phone: (510) 548-8777
Fax: (510) 548-0305

The provider's authorized official is Richard T. Niemi .
The authorized official title is Ceo and has the following contact phone number (916) 622-0267.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 9/28/2020.


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 PharmacyPHY55419CALIFORNIAYes

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
12160470OTHERPK

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: 11/14/2023

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