Provider Demographics
NPI:1316041361
Name:CMP CONCEPTS INC
Entity Type:Organization
Organization Name:CMP CONCEPTS INC
Other - Org Name:CMP CONCEPTS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-628-0640
Mailing Address - Street 1:2940 SUMMIT ST
Mailing Address - Street 2:STE 2F
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3416
Mailing Address - Country:US
Mailing Address - Phone:510-628-0640
Mailing Address - Fax:510-291-9856
Practice Address - Street 1:2940 SUMMIT ST
Practice Address - Street 2:STE 2F
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3416
Practice Address - Country:US
Practice Address - Phone:510-628-0640
Practice Address - Fax:510-291-9856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
CAPHY481993336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5623497OtherNCPDP PROVIDER IDENTIFICATION NUMBER