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General NPI Number Information
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NPI Number | 1447535224
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Entity Type | Organization
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Legal Business Name | PHARMACY COMPOUNDING SOLUTIONS LLC
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 2310 MILDRED ST W STE 138
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-6055
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Country | US
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Telephone | 253-564-2323
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Fax | 253-564-3131
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Provider Business Mailing Address
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Address Line | PO BOX 2028
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City | MILTON
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State | WA
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Zip | 98354-2028
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Country | US
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Telephone | 253-564-2323
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Fax | 253-564-3131
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Authorized Official
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Title or Position | MEMBER
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Name | ROBERT DOUD
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Credential |
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Telephone | 253-564-2323
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHARCF60244668
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License Number State | WA
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