Medford Compounding & Specialty Pharmacy Llc
LBN: Medford Compounding & Specialty Pharmacy Llc
Medford Compounding & Specialty Pharmacy Llc is an health care organization with primary practice located at 2612 Route 112 , Medford NY 11763-2522. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty.
Medford Compounding & Specialty Pharmacy Llc can be contacted via phone (631) 693-1403, or through Koller, Crystal via phone (631) 475-4141.
Contact Information
Primary practice address
2612 Route 112
Medford NY 11763-2522
Phone: (631) 693-1403
Fax: (631) 654-1508
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Compounding Pharmacy | 3336C0004X | 031387 | New York |
Profile Details
| NPI number | 1669721239 |
|---|---|
| LBN Legal business name | Medford Compounding & Specialty Pharmacy Llc |
| DBA Doing business as | Medford Compounding & Specialty Pharmacy Llc |
| Authorized official | Koller, Crystal |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 29th, 2012 |
| Last updated | Apr 4th, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669721239 | NPPES |
| Other | 2136843 | PK |
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