The Compounding Shoppe &Farmacy,LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

11396 Issued in NC

Legal business name

THE COMPOUNDING SHOPPE &FARMACY,LLC

Practice address

2001 S Main St
Wake Forest, NC 27587-1649

Phone

(919) 569-0500

Fax

(919) 556-4288

NPI assigned

Dec 4, 2012

Organization subpart

No

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

Authorized official

Name

David Nicholas Holt

Title

Owner

Phone

(919) 215-2307

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1851636799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275871649",
            "telephone_number": "919-569-0500",
            "fax_number": "919-556-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275871649",
            "telephone_number": "919-569-0500",
            "fax_number": "919-556-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COMPOUNDING SHOPPE &FARMACY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-215-2307"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NC",
            "license": "11396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.