| NPI | 1952706558 | 
|---|---|
| Doing Business As | SUPREME COMPOUNDING | 
| Entity Type | Organization | 
| Authorized Contact | SHYAMALA SURADA Pharmacist 571-230-2884  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 29521)  | 
| Enumeration Date | 2014-10-27 | 
| Last Update Date | 2014-10-27 |