| NPI | 1386471894 |
|---|---|
| Doing Business As | SOUTHERN BLEND COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DUSTIN BEARD Owner 423-718-8521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2024-09-18 |