| NPI | 1184723652 |
|---|---|
| Doing Business As | THE COMPOUNDING LAB/INDEPENDENT RX PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TIM CLARK President 937-723-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OH 021231250) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-11-16 |