# COMPOUNDING CENTER AT THE TIDES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942841911
- **Authorized official:** EMERALD TODD (MEDICAL ASSISTANT)
- **Authorized official phone:** (843) 400-4060

## Contact information

- **Practice address:** 180 WINGO WAY STE 106, MOUNT PLEASANT, SC 29464-1810
- **Practice address phone:** (843) 400-4060
- **Mailing address:** 180 WINGO WAY STE 106, MOUNT PLEASANT, SC 29464-1810
- **Mailing address phone:** (843) 400-4060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2019
- **Last updated:** 10/01/2019