Healthcare Provider Details

I. General information

NPI: 1033089909
Provider Name (Legal Business Name): OMNISCRIPT COMPOUNDING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 E BELL RD STE 163
PHOENIX AZ
85032-2240
US

IV. Provider business mailing address

4045 E BELL RD STE 163
PHOENIX AZ
85032-2240
US

V. Phone/Fax

Practice location:
  • Phone: 602-971-6950
  • Fax: 602-404-2504
Mailing address:
  • Phone: 602-971-6950
  • Fax: 602-404-2504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. KRISTINE LOWE
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 602-971-6950