NPIMap

Organization Active NPI

Compounder, LLC

  • Compounding Pharmacy
  • Columbia, MD
National Provider Identifier
1770849424
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
PW0213 Issued in MD
Legal business name
COMPOUNDER, LLC
Practice address
6345 Woodside Court #102
Columbia, MD 21046-3224
Phone
(410) 309-7926
Fax
(410) 309-5956
NPI assigned
Apr 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Dr. Ralph Lynn Shumake Jr., PHARMACY DOCTOR
Title
Pharmacist
Phone
(888) 248-3266

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PW0213 MD
Community/Retail Pharmacy 3336C0003X PW0213 MD
Compounding Pharmacy 3336C0004X PW0213 MD Primary

Addresses

Primary practice location

6345 Woodside Court #102
Columbia, MD 21046-3224

Mailing address

6345 Woodside CT Ste 102
Suite #102
Columbia, MD 21046-3224
Phone (410) 309-7926

Other names 1

  • VitaScript Pharmacy & Nutrition Center Doing business as

National Provider Directory

National Provider Directory

Locations

6345 Woodside Ct
Ste 102
Columbia, MD 21046
Phone (410) 309-7926

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1770849424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6345 WOODSIDE CT STE 102",
            "address_2": "SUITE #102",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463224",
            "telephone_number": "410-309-7926",
            "fax_number": "410-309-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 WOODSIDE COURT #102",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463224",
            "telephone_number": "410-309-7926",
            "fax_number": "410-309-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPOUNDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "SHUMAKE",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "888-248-3266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHARMACY DOCTOR"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "PW0213",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "PW0213",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MD",
            "license": "PW0213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VitaScript Pharmacy & Nutrition Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.