Procompounding of the Carolinas 1 Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

13796 Issued in NC

Legal business name

PROCOMPOUNDING OF THE CAROLINAS 1 INC

Practice address

77 Airport Rd
Arden, NC 28704-9531

Phone

(423) 975-0597

NPI assigned

Aug 16, 2018

Organization subpart

No

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

Authorized official

Name

Jason K Guinn, MBA

Title

Chief Financial Officer

Phone

(423) 975-0597

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProCompounding Pharmacy Doing business as

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1396225694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6075",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376026075",
            "telephone_number": "423-975-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 AIRPORT RD",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287049531",
            "telephone_number": "423-975-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCOMPOUNDING OF THE CAROLINAS 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "GUINN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "423-975-0597",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NC",
            "license": "13796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF PHARMACY",
            "identifier": "13796",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProCompounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Arden, NC
• Providers in Arden, NC by specialty
• Compounding Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.