Professional Compounding of Roswell Inc
Organization Active NPI Compounding Pharmacy · Roswell, NM
NPI 1689714552 · NPPES record last updated Aug 31, 2015
Key facts
- NPI
- 1689714552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Compounding Pharmacy 3336C0004X
- License
- PH00002305 (NM)
- Legal business name
- 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
- Organization subpart
- No
Authorized official
- Name
- Charles Shannon, RPH
- Title
- President
- Phone
- (575) 622-6578
National Provider Directory
Locations
700 N Union Ave
Roswell, NM 88201
Phone (575) 622-6571
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Compounding Pharmacy | 3336C0004X | PH00002305 | NM | Yes |
Addresses
Primary practice location
700 N Union Ave
Roswell, NM 88201-3956
Mailing address
700 N Union Ave
Roswell, NM 88201-3956
Phone (575) 622-6578
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2058933 | Other | PK |
Other names
- PROFESSIONAL COMPOUNDING OF ROSWELL INC
Other providers in Roswell, NM
- James Prince
- Priority Medical and Health Services LLC
- PRN Medical
- Pro Active Hearing LLC
- Pro-Optical Express LTD.
- Veronica Puckett
- Kaitlyn Pults
- Purple Cow Case Management LLC
- Roslyn Kate Pursley
- Ryann H Putman
All providers in Roswell, NM · Compounding Pharmacy in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.