NPIMap

Organization Active NPI

South River Compounding Pharmacy LLC

  • Compounding Pharmacy
  • Henrico, VA
National Provider Identifier
1942934633
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
Legal business name
SOUTH RIVER COMPOUNDING PHARMACY LLC
Practice address
3656 Mayland CT
Henrico, VA 23233-1409
Phone
(804) 897-6447
Fax
(804) 967-6449
NPI assigned
Jul 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Authorized official

Name
Jennifer Parks Horn, RPHNPI 1346910981
Title
Pharmacist in Charge
Phone
(804) 897-6447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X Primary

Addresses

Primary practice location

3656 Mayland CT
Henrico, VA 23233-1409

Mailing address

3656 Mayland CT
Henrico, VA 23233-1409
Phone (804) 897-6447

National Provider Directory

National Provider Directory
Tax ID family
South River Compounding Pharmacy LLC2 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.

Practitioners & affiliated clinicians

Practitioners 3

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": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1942934633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 MAYLAND CT",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331409",
            "telephone_number": "804-897-6447",
            "fax_number": "804-967-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3656 MAYLAND CT",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331409",
            "telephone_number": "804-897-6447",
            "fax_number": "804-967-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH RIVER COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "HORN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "PARKS",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "804-897-6447",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.