Rock Valley Compounding Pharmacy LLC
Pharmacy, Compounding Pharmacy in Rockford, IL. Organization (NPI-2).
NPI number1376802462
StatusActive
Last updated in NPPESAug 4, 2022
Details
- NPI
- 1376802462
- Entity type
- Organization (NPI-2)
- Legal business name
- Rock Valley Compounding Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- May 9, 2012
- Certification date
- Aug 4, 2022
- Last updated
- Aug 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0004X | Pharmacy, Compounding Pharmacy | – | – | Yes |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 054018235 | IL | |
| 333600000X | Pharmacy | – | – |
Other names
- Rock Valley Compounding Pharmacy LLC (Doing Business As)
Practice location
811 S Perryville Rd Unit 109Rockford, IL 61108-4323
Phone 779-423-0542 · Fax 779-545-2277
Mailing address
811 S Perryville Rd Unit 109Rockford, IL 61108-4323
Phone 779-423-0542 · Fax 779-545-2277
Authorized official
Jonathan M Lehan
Pharmacist In Charge
7794230542
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