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General NPI Number Information
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NPI Number | 1518395656
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Entity Type | Organization
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Legal Business Name | COMPOUNDING SOLUTIONS PHARMACY LLC
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 115 PELHAM RD STE 12
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City | GREENVILLE
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State | SC
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Zip | 29615-2155
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Country | US
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Telephone | 864-558-0508
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Fax | 864-558-0509
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Provider Business Mailing Address
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Address Line | 115 PELHAM RD STE 12
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City | GREENVILLE
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State | SC
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Zip | 29615-2155
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Country | US
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Telephone | 864-558-0508
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Fax | 864-558-0509
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Authorized Official
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Title or Position | OWNER/PIC
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Name | PAMELA BRAMLETT
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Credential |
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Telephone | 864-558-0507
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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 | 14874
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License Number State | SC
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