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Organization
INTRATHECAL COMPOUNDING SPECIALISTS LLC
Active
Organization
INTRATHECAL COMPOUNDING SPECIALISTS LLC
Active
Other names
INTRATHECAL COMPOUNDING SPECIALISTS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STUART BURGESS RPH (DIR OF PHARMACY)
(337) 237-6077
Entity
Organization
Contact information
Practice address
206 A JACOBS RUN, SCOTT, LA 70583
(337) 237-6077
(337) 237-8841
Mailing address
206 A JACOBS RUN, SCOTT, LA 70583
(337) 237-6077
(337) 237-8841
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5856
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035607
PK
—
Enumeration date
02/19/2008
Last updated
12/09/2013
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