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General NPI Number Information
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NPI Number | 1477864031
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Entity Type | Organization
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Legal Business Name | P3 COMPOUNDING, LLC
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 8848 CEDAR SPRINGS LN SUITE 100
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City | KNOXVILLE
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State | TN
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Zip | 37923-5415
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Country | US
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Telephone | 865-769-5180
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Fax | 865-769-5179
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Provider Business Mailing Address
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Address Line | 8848 CEDAR SPRINGS LN SUITE 100
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City | KNOXVILLE
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State | TN
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Zip | 37923-5415
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Country | US
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Telephone | 865-769-5180
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Fax | 865-769-5179
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY MARK SMITH
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Credential | PHARMD
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Telephone | 865-769-5180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 4779
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License Number State | TN
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