| NPI | 1205161775 |
|---|---|
| Doing Business As | KOSHLAND PHARM: CUSTOM COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PETER KOSHLAND President / CEO 510-318-2852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: CA PHY50041) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2016-08-04 |