Innovative Intrathecal Solutions Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY49935 Issued in CA

Legal business name

INNOVATIVE INTRATHECAL SOLUTIONS INC

Doing business as

Innovative Compounding Pharmacy

Practice address

41538 Eastman Dr
Murrieta, CA 92562-8007

Phone

(951) 304-9530

Fax

(951) 304-9540

NPI assigned

Dec 26, 2006

Last updated

Jun 20, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anthony Barrack, RPH

Title

President

Phone

(951) 304-9530

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• INNOVATIVE COMPOUNDING PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1093870412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41538 EASTMAN DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628007",
            "telephone_number": "951-304-9530",
            "fax_number": "951-304-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41538 EASTMAN DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628007",
            "telephone_number": "951-304-9530",
            "fax_number": "951-304-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE INTRATHECAL SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "BARRACK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-304-9530",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49935",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1997382",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA45898",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INNOVATIVE COMPOUNDING PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.