Custom Compounding Phy Llc

LBN: Custom Compounding Pharmacy Llc
Custom Compounding Phy Llc is an health care organization with primary practice located at 3816 Ringgold Rd , Chattanooga TN 37412-1640. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Custom Compounding Pharmacy Llc can be contacted via phone (423) 629-0353, or through Musick, Joe via phone (423) 629-0353.

Contact Information

Primary practice address
3816 Ringgold Rd Chattanooga TN 37412-1640
Phone: (423) 629-0353
Fax: (423) 629-9646
Website:
Map and Directions
Authorized official contact:
Name: Musick, Joe RPH
Phone: (423) 629-0353

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Community/Retail Pharmacy 3336C0003X 0000003295 Tennessee
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1417095407
LBN Legal business name Custom Compounding Pharmacy Llc
DBA Doing business as Custom Compounding Phy Llc
Authorized official Musick, Joe RPH
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2007
Last updated Jul 20th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417095407 NPPES
Other 4432061 OTHER ID NUMBER
Other 4432061 OTHER ID NUMBER

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