Organization
MARILU LLC
Active
Other names
Southern Blend Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN BEARD (OWNER)
(423) 718-8521
Entity
Organization
Contact information
Practice address
125 BATTLEFIELD CROSSING CT, RINGGOLD, GA 30736-5176
(706) 841-0540
Mailing address
578 CLASSIC TRL, RINGGOLD, GA 30736-5895
(423) 718-8521
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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