Organization
PROCOMPOUNDING OF THE CAROLINAS 1 INC
Active
Other names
ProCompounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASON K GUINN MBA (CHIEF FINANCIAL OFFICER)
(423) 975-0597
Entity
Organization
Contact information
Practice address
77 AIRPORT RD, ARDEN, NC 28704-9531
(423) 975-0597
Mailing address
PO BOX 6075, JOHNSON CITY, TN 37602-6075
(423) 975-0597
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
13796
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13796
NORTH CAROLINA BOARD OF PHARMACY
NC
Enumeration date
08/16/2018
Last updated
08/16/2018
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