Provider Demographics
NPI:1831341577
Name:NATIOAL COMPOUNDING INSTITUTE INC
Entity type:Organization
Organization Name:NATIOAL COMPOUNDING INSTITUTE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULIR-SAADEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-551-7195
Mailing Address - Street 1:250 E YALE LOOP
Mailing Address - Street 2:SUITE C
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4697
Mailing Address - Country:US
Mailing Address - Phone:866-624-6241
Mailing Address - Fax:866-615-5352
Practice Address - Street 1:1851 LANGLEY AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5623
Practice Address - Country:US
Practice Address - Phone:866-624-6241
Practice Address - Fax:866-615-5352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336M0002X, 3336S0011X
CAPHY484413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5632270OtherNCPDP PROVIDER IDENTIFICATION NUMBER