Professional Compounding of Roswell Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PH00002305 Issued in NM

Legal business name

PROFESSIONAL COMPOUNDING OF ROSWELL INC

Doing business as

Professional Compounding of Roswell Inc

Practice address

700 N Union Ave
Roswell, NM 88201-3956

Phone

(575) 622-6578

Fax

(575) 623-3801

NPI assigned

Feb 8, 2007

Last updated

Aug 31, 2015By 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

Charles Shannon, RPH

Title

President

Phone

(575) 622-6578

Specialties & licenses 2

Addresses

Other names 1

• PROFESSIONAL COMPOUNDING OF ROSWELL INC Doing business as

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1689714552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N UNION AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013956",
            "telephone_number": "575-622-6578",
            "fax_number": "575-623-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N UNION AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013956",
            "telephone_number": "575-622-6578",
            "fax_number": "575-623-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL COMPOUNDING OF ROSWELL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-622-6578",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NM",
            "license": "PH00002305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL COMPOUNDING OF ROSWELL INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Roswell, NM
• Providers in Roswell, NM by specialty
• Compounding Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.