Island Compounding Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

16203 Issued in SC

Legal business name

ISLAND COMPOUNDING PHARMACY LLC

Doing business as

Stephens Compounding Pharmacy

Practice address

55 Mathews Dr Ste 215
Hilton Head Island, SC 29926-3731

Phone

(843) 686-3040

Fax

(843) 686-3035

NPI assigned

Nov 25, 2015

Last updated

Nov 25, 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

Dr. Wilhemina Smith Fry, PHARM.D.

Title

Owner/Sole Member

Phone

(843) 686-3040

Specialties & licenses 1

Addresses

Other names 1

• Stephens Compounding Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1891169090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MATHEWS DR STE 215",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299263731",
            "telephone_number": "843-686-3040",
            "fax_number": "843-686-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MATHEWS DR STE 215",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299263731",
            "telephone_number": "843-686-3040",
            "fax_number": "843-686-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "WILHEMINA",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "843-686-3040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "16203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephens Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathy Jean Hussong, PHARMD
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• Island Nurses Healthcare Advocates LLC
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• Island Sleep Lab LLC

• Community/Retail Pharmacy in Hilton Head Island, SC
• Providers in Hilton Head Island, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.