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General NPI Number Information
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NPI Number | 1255045118
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Entity Type | Organization
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Legal Business Name | MUSELY COMPOUNDING PHARMACY EAST LLC
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 305 SHAWNEE NORTH DR STE 600
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City | SUWANEE
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State | GA
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Zip | 30024-6714
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Country | US
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Telephone | 470-328-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 305 SHAWNEE NORTH DR STE 600
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City | SUWANEE
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State | GA
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Zip | 30024-6714
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Country | US
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Telephone | 470-328-3001
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | STEVE BUCHANAN
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Credential |
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Telephone | 925-708-1881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order 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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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