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General NPI Number Information
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NPI Number | 1295816387
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Entity Type | Organization
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Legal Business Name | COMPOUNDING CORNER INC.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 61000 SEVENTEENTH ST.
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City | LACOMBE
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State | LA
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Zip | 70445-0217
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Country | US
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Telephone | 985-882-6333
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Fax | 985-882-5307
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Provider Business Mailing Address
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Address Line | PO BOX 217
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City | LACOMBE
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State | LA
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Zip | 70445-0217
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Country | US
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Telephone | 985-882-6333
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Fax | 985-882-5307
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Authorized Official
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Title or Position | DIRECTOR/PHARMACIST IN CHARGE
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Name | MR. GEORGE BELTHAZAR MULLER
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Credential | R. PH.
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Telephone | 985-882-6333
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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 | 4548
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License Number State | LA
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