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Organization
TIGER TOWN COMPOUNDING INC
Active
Organization
TIGER TOWN COMPOUNDING INC
Active
Other names
TIGER TOWN COMPOUNDING
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BOST PHRMD (OWNER)
(706) 335-0099
Entity
Organization
Contact information
Practice address
2025 HOMER RD, COMMERCE, GA 30529-1255
(706) 335-0099
(706) 335-0078
Mailing address
2025 HOMER RD, COMMERCE, GA 30529-1255
(706) 335-0099
(706) 335-0078
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHRE09389
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016757
PK
—
Enumeration date
11/07/2007
Last updated
08/02/2013
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