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General NPI Number Information
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NPI Number | 1164524310
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Entity Type | Organization
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Legal Business Name | GRIFFS COMPOUNDING CENTER INC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 3210 AVENUE B STE A
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-4314
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Country | US
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Telephone | 308-635-9800
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Fax | 308-635-9899
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Provider Business Mailing Address
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Address Line | 3210 AVENUE B STE A
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-4314
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Country | US
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Telephone | 308-635-9800
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Fax | 308-635-9899
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Authorized Official
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Title or Position | OWNER
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Name | CLARK GRIFFITH
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Credential | BACHELOR
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Telephone | 308-635-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 3013
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License Number State | NE
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