Premium Compounding Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

114813 Issued in AL

Legal business name

PREMIUM COMPOUNDING INC

Practice address

3220 Highway 31 S Ste A2
Decatur, AL 35603-1731

Phone

(256) 566-8011

NPI assigned

May 29, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Samuel Marion Costello, RPHNPI 1629120894

Title

President

Phone

(256) 566-8011

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Marion Costello, REG PHARMACIST

  • Pharmacist
  • Decatur, AL
  • NPI 1629120894
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1013408772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 HIGHWAY 31 S STE A2",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031731",
            "telephone_number": "256-566-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 HIGHWAY 31 S STE A2",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031731",
            "telephone_number": "256-566-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM COMPOUNDING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "MARION",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-566-8011",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AL",
            "license": "114813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James E Posey Jr., M.D.
• Dale A Potter, O.D.
• Joel Alonzo Powell Jr., M.D.
• Premise Health of Alabama Medical PC
• Premium Compounding
• Ashley Elizabeth Presley, FNP-BC
• Price-Denton Endodontics, LLC
• Kristine Capell Price, M.ED., CCC/SLP
• Lane Mathis Price, M.D.
• Stephen Ronald Price

• Compounding Pharmacy in Decatur, AL
• Providers in Decatur, AL by specialty
• Compounding Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.