| NPI | 1275744567 |
|---|---|
| Doing Business As | THE COMPOUNDING SHOP |
| Entity Type | Organization |
| Authorized Contact | BURT L. PATTERSON President / Pharmacist 228-875-0158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2008-06-23 |