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CUSTOM COMPOUNDING PHARMACY LLC

Medical Equipment Supplier Yellow Pages

Chattanooga, Tennessee

Provider NPI: 1417095407

Organization Information:
Organization Name:  CUSTOM COMPOUNDING PHARMACY LLC


Practice Location:
3816 RINGGOLD RD  CHATTANOOGA, TN 37412 US
Tel: 423-629-0353  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336C0003XSuppliers
Pharmacy
Community/Retail Pharmacy
N3336C0004XSuppliers
Pharmacy
N333600000XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
TN0000003295

Other Provider Identifiers:

IssuerNumberStateType
OTHER ID NUMBER443206101
OTHER ID NUMBER-COMMERCIAL NUMBER443206101
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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