VALOR COMPOUNDING PHARMACY, INC – NPI #1881712701
Pharmacy

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

Health Care Provider Taxonomy Code for Pharmacy

VALOR COMPOUNDING PHARMACY, INC is a pharmacy located in BERKELEY, CA. NPPES has assigned the NPI number 1881712701 to VALOR COMPOUNDING PHARMACY, INC on March 27, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is WELLSPRING COMPOUNDING PHARMACY, INC. The NPI data also shows multiple names associated with this provider such as Valor Compounding Pharmacy and 2 other listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336C0004X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Compounding Pharmacy

The NPI profile was previously updated about 6 years ago on Sep 28, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for VALOR COMPOUNDING PHARMACY, INC below.

NPI Profile for
VALOR COMPOUNDING PHARMACY, INC

NPI Number
1881712701
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
VALOR COMPOUNDING PHARMACY, INC
Former Legal Business Name: WELLSPRING COMPOUNDING PHARMACY, INC
Other name(s)
All associated names:
Doing Business As (dba)
Valor Compounding Pharmacy
Doing Business As (dba)
Wellspring Compounding Pharmacy
Former Legal Business Name
Wellspring Compounding Pharmacy, Inc
Primary location
2461 SHATTUCK AVE.
BERKELEY, CA 94704
Phone: (510) 548-8777 Fax: (510) 548-0305
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
RICHARD NIEMI
CEO
Phone: (916) 622-0267
Updated
Certification Date
Sep 28, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for VALOR COMPOUNDING PHARMACY, INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPK2160470
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0004X
- Pharmacy / Compounding Pharmacy (Primary)		 CA PHY55419
333600000X
- Pharmacy

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.