Camelback Compounders LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

CAMELBACK COMPOUNDERS LLC

Doing business as

Camelback Compounding Pharmacy

Practice address

4416 E Camelback Rd
Phoenix, AZ 85018-2824

Phone

(602) 840-1111

Fax

(602) 840-0111

NPI assigned

Sep 13, 2022

Last updated

Sep 13, 2022By 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

Jace Anthony Clark, PHARMDNPI 1699056028

Title

Owner/Pharmacist

Phone

(602) 840-1111

Specialties & licenses 1

Addresses

Other names 1

• Camelback Compounding Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jace Anthony Clark, PHARMD

  • Pharmacist
  • Phoenix, AZ
  • NPI 1699056028
  NPD Authorized official

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1932821493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4416 E CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182824",
            "telephone_number": "602-840-1111",
            "fax_number": "602-840-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4416 E CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182824",
            "telephone_number": "602-840-1111",
            "fax_number": "602-840-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELBACK COMPOUNDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JACE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "602-840-1111",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelback Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isabel Christina Camargo
• Michele Cambria, P.A.-C.
• Juliana Del Valle Camejo, PA
• Camelback Advanced Therapy LLC (Camelback Advanced Therapy)
• Camelback Chiropractic Centers II PLLC
• Camelback Counseling LLC
• Camelback Dental Care PLLC
• Camelback Dermatology & Skin Surgery, Inc
• Camelback Hospice LLC
• Camelback Imaging Holdings LLC

• Compounding Pharmacy in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Compounding Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.