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General NPI Number Information
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NPI Number | 1710377916
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Entity Type | Organization
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Legal Business Name | PRESTIGE COMPOUNDING
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 2215 HIGHWAY 78 STE 90
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City | DORA
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State | AL
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Zip | 35062-4540
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Country | US
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Telephone | 205-313-3560
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1177
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City | DORA
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State | AL
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Zip | 35062-1177
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Country | US
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Telephone |
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Fax | 888-574-4888
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Authorized Official
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Title or Position | PARTNER
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Name | DR. WILLIAM B MYERS
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Credential |
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Telephone | 205-313-3560
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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 | AL
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