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INNOVATIVE COMPOUNDING PHARMACY
NPI 1083829170
Pharmacy - Compounding Pharmacy in Folsom, CA

Active since May 11, 2007CLIA 05D2219107 · Waiver
820 WALES DR, SUITE 3, FOLSOM, CA 95630(916) 984-9222(916) 458-8267 Get Directions Write a Review

NPPES record last updated: August 3, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Innovative Compounding Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVATIVE COMPOUNDING PHARMACY (NPI 1083829170) is a healthcare organization registered as a compounding pharmacy in Folsom, California and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through March 31, 2027 and lists Anna Rashidi, Ownerpharmacist, as its authorized official.

NPPES Registry Identity

NPI1083829170
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameINNOVATIVE COMPOUNDING PHARMACY
Location Address820 WALES DR, SUITE 3Folsom, CA 95630-5546
Mailing Address820 Wales Dr, Suite 3Folsom, CA 95630-5546 · (916) 984-9222 · Fax (916) 458-8267
Phone(916) 984-9222
Fax(916) 458-8267
Organization SubpartNo
Authorized OfficialAnna RashidiOwnerpharmacist · (916) 984-9222
Enumeration DateMay 11, 2007
Last NPPES UpdateAugust 3, 2007
✔ NPI 1083829170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License✔ Licensed in CA · PHY 48417
Definition
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.
820 WALES DR, Folsom, CA 95630
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2219107

Innovative Compounding Inc Dba Innovative Compounding Pharmacy · Folsom, CA
Active · expires Mar 31, 2027
CLIA Number05D2219107
Laboratory TypePharmacy
Certificate Effective DateApril 1, 2025
Certificate Expiration DateMarch 31, 2027
Laboratory DirectorMasoud Rashidi
Laboratory Phone(916) 984-9222
Laboratory LocationInnovative Compounding Inc Dba Innovative Compounding Pharmacy820 Wales Dr, Folsom, CA 95630
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHAWN MARTIN WEDWORTH PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
820 WALES DR
FOLSOM, CA 95630
Sacramento County (916) 984-9222

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovative Compounding Pharmacy's NPI number?

The NPI number for Innovative Compounding Pharmacy is 1083829170. It was assigned to this organization in the NPPES registry on May 11, 2007.

Where is Innovative Compounding Pharmacy located?

Innovative Compounding Pharmacy is located at 820 Wales Dr Suite 3, Folsom, CA 95630. The listed phone number is (916) 984-9222.

What is Innovative Compounding Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

Does Innovative Compounding Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2219107) is associated with this NPI, valid through March 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Innovative Compounding Pharmacy accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 37 other insurers list Innovative Compounding Pharmacy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Innovative Compounding Pharmacy was last updated on August 3, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.