Compounding Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2113 Issued in TN

Legal business name

COMPOUNDING PHARMACY LLC

Practice address

310 Bluff City Hwy
Bristol, TN 37620-4602

Phone

(423) 764-4136

Fax

(423) 764-5167

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Wesley Waters III, PHARMDNPI 1083788343

Title

Owner/Pharmacist

Phone

(406) 531-5888

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 2

• ANDERSON COMPOUNDING PHARMACY Doing business as
• WATERS WELLNESS Doing business as

Tax ID family

Anderson Compounding Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Compounding Pharmacy LLC

  • Pharmacy
  • Bristol, TN
  • NPI 1659058733
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wesley V Waters III, PHARM.D., RPH

  • Pharmacist
  • Pittsboro, NC
  • NPI 1083788343
  NPD Authorized official

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1760437347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 BLUFF CITY HWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204602",
            "telephone_number": "423-764-4136",
            "fax_number": "423-764-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BLUFF CITY HWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204602",
            "telephone_number": "423-764-4136",
            "fax_number": "423-764-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "406-531-5888",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "2113",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4425903",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8508895",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4425903",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANDERSON COMPOUNDING PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WATERS WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cecil Eugene Collins Jr., D.C.
• John Wayne Collins, DO
• Sidney W Collins Jr., MD
• Courtney C Colobro
• Compounding Pharmacy LLC
• Cassondra Nichole Compton, CRNA
• Jacob Compton, M.D.
• Jenifer C Conerly, NP
• Kimberly Conley, OTRL
• Angela Lynn Conner, MS,RD,LDN

• Community/Retail Pharmacy in Bristol, TN
• Providers in Bristol, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.