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Organization

TIGER TOWN COMPOUNDING INC

Active
Other names
TIGER TOWN COMPOUNDING
Organization subpart
No

Provider details

NPI number
Authorized official
KIM BOST PHRMD (OWNER)
(706) 335-0099
Entity
Organization

Contact information

Practice address
2025 HOMER RD, COMMERCE, GA 30529-1255
(706) 335-0099
(706) 335-0078
Mailing address
2025 HOMER RD, COMMERCE, GA 30529-1255
(706) 335-0099
(706) 335-0078

Taxonomy

Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHRE09389
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016757
PK
Enumeration date
11/07/2007
Last updated
08/02/2013
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