Marilu LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

MARILU LLC

Doing business as

Southern Blend Compounding Pharmacy

Practice address

125 Battlefield Crossing CT
Ringgold, GA 30736-5176

Phone

(706) 841-0540

NPI assigned

Sep 18, 2024

Last updated

Sep 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dustin BeardNPI 1184211633

Title

Owner

Phone

(423) 718-8521

Specialties & licenses 1

Addresses

Other names 1

• Southern Blend Compounding Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dustin Adam Beard, PHARM.D.

  • Pharmacist
  • Ringgold, GA
  • NPI 1184211633
  Authorized official Same address or phone

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1386471894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 CLASSIC TRL",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307365895",
            "telephone_number": "423-718-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BATTLEFIELD CROSSING CT",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307365176",
            "telephone_number": "706-841-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-718-8521"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Blend Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Athena Leigh Magdaong, PT, DPT
• Gisel Abigail Maldonado
• Nancy Manning, RN
• Hicks Corey Manson
• Ashlyn Grace Maples
• Sandra Ann Martin, FNP-BC
• Joanna Massey
• McCarver Family Chiropractic
• John Patrick McCarver, D.C.
• Katherine S McClellan, MD

• Compounding Pharmacy in Ringgold, GA
• Providers in Ringgold, GA by specialty
• Compounding Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.