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General NPI Number Information
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NPI Number | 1275894123
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Entity Type | Organization
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Legal Business Name | WHEELERS CUSTOM COMPOUNDING INC
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 327 ROMANY RD
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City | LEXINGTON
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State | KY
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Zip | 40502-2403
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Country | US
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Telephone | 859-554-2716
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Fax | 859-554-0513
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Provider Business Mailing Address
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Address Line | 327 ROMANY RD
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City | LEXINGTON
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State | KY
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Zip | 40502-2403
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Country | US
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Telephone | 859-554-2716
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Fax | 859-554-0513
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | CLAIRE LEWIS
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Credential |
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Telephone | 859-396-6244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | P07527
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License Number State | KY
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