Organization
CREATIVE COMPOUNDING SOLUTIONS LLC
Active
Other names
Medicine Chest
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CAMPBELL (OWNER)
(260) 483-3169
Entity
Organization
Contact information
Practice address
2803 E STATE BLVD, FORT WAYNE, IN 46805-4732
(260) 483-3169
(260) 483-3160
Mailing address
2803 E STATE BLVD, FORT WAYNE, IN 46805-4732
(260) 483-3169
(260) 483-3160
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
60002334A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169538
PK
—
Enumeration date
01/18/2007
Last updated
07/19/2018
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