Pacific Compounding Pharmacy and Consultations, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY47493 Issued in CA

Legal business name

PACIFIC COMPOUNDING PHARMACY AND CONSULTATIONS, INC.

Doing business as

Pacific Compunding Pharmacy and Consultations

Practice address

312 Lincoln Ctr
Stockton, CA 95207-2627

Phone

(209) 474-7271

Fax

(209) 474-7168

NPI assigned

Nov 3, 2006

Last updated

Jan 23, 2017By 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

Marie Cottman, PHARM DNPI 1043322746

Title

President

Phone

(209) 474-7271

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• PACIFIC COMPUNDING PHARMACY AND CONSULTATIONS Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marie A Cottman, PHARM. D.

  • Pharmacist
  • Stockton, CA
  • NPI 1043322746
  Authorized official Same address or phone

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1912086695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 LINCOLN CTR",
            "address_2": "NO SUITE NUMBER",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952072627",
            "telephone_number": "209-474-7271",
            "fax_number": "209-474-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 LINCOLN CTR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952072627",
            "telephone_number": "209-474-7271",
            "fax_number": "209-474-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COMPOUNDING PHARMACY AND CONSULTATIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "COTTMAN",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-474-7271",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY47493",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2115225",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACIFIC COMPUNDING PHARMACY AND CONSULTATIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Stockton, CA
• Providers in Stockton, 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 Jan 23, 2017; 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.