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Organization
MADISON MEDICAL COMPOUNDING PHARMACY
Active
Organization
MADISON MEDICAL COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN LEANN CHAMBERS PHARM.D. (OPERATIONS MANAGER)
(662) 820-4305
Entity
Organization
Contact information
Practice address
117 FOUNTAINS BLVD STE 2, MADISON, MS 39110-6317
(601) 707-7545
Mailing address
117 FOUNTAINS BLVD STE 2, MADISON, MS 39110-6317
(601) 707-7545
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
17118
MS
3336S0011X
Specialty Pharmacy
17118
MS
Other
Enumeration date
08/24/2018
Last updated
09/23/2026
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