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Organization
COMPOUNDING CORNER PHARMACY, INC.
Active
Organization
COMPOUNDING CORNER PHARMACY, INC.
Active
Other names
Compounding Corner Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MAGUADOG (PIC)
(281) 494-7777
Entity
Organization
Contact information
Practice address
1730 WILLIAMS TRACE BLVD STE K, SUGAR LAND, TX 77478-4055
(281) 494-7777
(281) 494-7770
Mailing address
1730 WILLIAMS TRACE BLVD STE K, SUGAR LAND, TX 77478-4055
(281) 494-7777
(281) 494-7770
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
23038
TX
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154374
PK
—
Enumeration date
10/02/2015
Last updated
10/02/2015
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