| NPI | 1417095407 |
|---|---|
| Doing Business As | CUSTOM COMPOUNDING PHY LLC |
| Entity Type | Organization |
| Authorized Contact | JOE MUSICK Pharmacist 423-629-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 0000003295) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-20 |