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General NPI Number Information
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NPI Number | 1518387240
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Entity Type | Organization
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Legal Business Name | COMPOUNDING CENTERS OF AMERICA
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 41254 HIGHWAY 195 STE G
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City | HALEYVILLE
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State | AL
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Zip | 35565-8114
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Country | US
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Telephone | 205-269-1224
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Fax |
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Provider Business Mailing Address
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Address Line | 41254 HIGHWAY 195 STE G
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City | HALEYVILLE
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State | AL
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Zip | 35565-8114
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Country | US
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Telephone | 205-269-1224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES KEVIN SWANN
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Credential |
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Telephone | 205-269-1224
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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 |
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License Number State |
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