Healthcare Provider Details

I. General information

NPI: 1144588278
Provider Name (Legal Business Name): INFINITY COMPOUNDING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 SE 28TH ST STE 2
BENTONVILLE AR
72712-3887
US

IV. Provider business mailing address

PO BOX 699
BENTONVILLE AR
72712-0699
US

V. Phone/Fax

Practice location:
  • Phone: 479-250-1443
  • Fax: 479-268-3478
Mailing address:
  • Phone: 479-250-1443
  • Fax: 479-268-3478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: TALMAGE JEREMY WHITEHEAD
Title or Position: CFO
Credential:
Phone: 870-347-2534