NPI 1902068216 · live from the CMS NPI Registry
Community Compounding Pharmacy
Pharmacy, Compounding Pharmacy in Lake Oswego, OR. National Provider Identifier 1902068216, active.
NPI record
| NPI | 1902068216 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Compounding Pharmacy 3336C0004X |
| Practice location | 6025 Jean Rd, Lake Oswego, OR 97035 |
| Practice phone | 503-303-7373 |
| Enumerated | June 27, 2008 |
| Last updated | April 18, 2017 |
| Authorized official | Suzanne Rosenberg, Owner |
| Other names | Community Compounding Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — |
| Pharmacy | 333600000X | — |
| Pharmacy, Compounding Pharmacy primary | 3336C0004X | RP0002481CS (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.