# ISLAND COMPOUNDING PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stephens Compounding Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891169090
- **Authorized official:** DR. WILHEMINA SMITH FRY PHARM.D. (OWNER/SOLE MEMBER)
- **Authorized official phone:** (843) 686-3040

## Contact information

- **Practice address:** 55 MATHEWS DR STE 215, HILTON HEAD ISLAND, SC 29926-3731
- **Practice address phone:** (843) 686-3040
- **Practice address fax:** (843) 686-3035
- **Mailing address:** 55 MATHEWS DR STE 215, HILTON HEAD ISLAND, SC 29926-3731
- **Mailing address phone:** (843) 686-3040
- **Mailing address fax:** (843) 686-3035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 16203 | SC | Yes |

## Other

- **Enumeration date:** 11/25/2015
- **Last updated:** 11/25/2015