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Organization
SOUTH RIVER COMPOUNDING PHARMACY, INC
Active
Organization
SOUTH RIVER COMPOUNDING PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAYLOR RICE JR. RPH (PRESIDENT)
(804) 897-6447
Entity
Organization
Contact information
Practice address
11420 W HUGUENOT RD, MIDLOTHIAN, VA 23113-1119
(804) 897-6447
(804) 897-6449
Mailing address
11420 W HUGUENOT RD, MIDLOTHIAN, VA 23113-1119
(804) 897-6447
(804) 897-6449
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0201003498
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8514585
—
VA
Enumeration date
10/12/2006
Last updated
02/15/2016
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