| NPI | 1700444163 |
|---|---|
| Doing Business As | COLLIERVILLE COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JEFFERY RYAN WOODEN Managing Partner 901-371-1075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2023-08-03 |