Healthcare Provider Details
I. General information
NPI: 1477364693
Provider Name (Legal Business Name): RMSS COMPOUNDING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 W 4TH ST
COOKEVILLE TN
38501
US
IV. Provider business mailing address
330 N OAK AVE
COOKEVILLE TN
38501-2440
US
V. Phone/Fax
- Phone: 931-559-6337
- Fax: 931-559-1002
- Phone: 931-559-6337
- Fax: 931-559-1002
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JONATHAN
CLINT
MELTON
Title or Position: OWNER
Credential: PHARM D.
Phone: 931-559-6337