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General NPI Number Information
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NPI Number | 1386784932
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Entity Type | Organization
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Legal Business Name | COMPOUND CARE PLUS LLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 1410 US HIGHWAY 98 UNIT G
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City | DAPHNE
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State | AL
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Zip | 36526-5110
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Country | US
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Telephone | 251-418-0010
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Fax | 866-832-2264
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Provider Business Mailing Address
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Address Line | 1410 US HIGHWAY 98 UNIT G
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City | DAPHNE
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State | AL
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Zip | 36526-5110
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Country | US
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Telephone | 251-418-0010
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Fax | 866-832-2264
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | ASHLEY B HAMMOND
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Credential | RPH
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Telephone | 251-418-0010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 112440
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License Number State | AL
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