Provider Demographics
NPI:1992126205
Name:MEDCOMPOUNDERS PHARMACY INC
Entity type:Organization
Organization Name:MEDCOMPOUNDERS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO /PHARMACIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARKZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:310-666-3987
Mailing Address - Street 1:3855 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:562-427-1999
Mailing Address - Fax:562-427-2999
Practice Address - Street 1:3855 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:562-427-1999
Practice Address - Fax:562-427-2999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-04
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy