Specialty RX Compounding & Wellness LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

SPECIALTY RX COMPOUNDING & WELLNESS LLC

Practice address

1625 Highway 51 Ste J
Ponchatoula, LA 70454-6594

Phone

(985) 320-4186

NPI assigned

Apr 8, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Kyle Douglas Talley, CPHT

Title

Cfo

Phone

(985) 974-6008

Specialties & licenses 2

Addresses

Other names 1

• Specialty RX Compounding & Wellness Doing business as

Locations

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1508619768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 HIGHWAY 51 STE J",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704546594",
            "telephone_number": "985-320-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 HIGHWAY 51 STE J",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704546594",
            "telephone_number": "985-320-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY RX COMPOUNDING & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "TALLEY",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "985-974-6008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty RX Compounding & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Ponchatoula, LA
• Providers in Ponchatoula, LA by specialty
• Compounding Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.