Organization
MSRX INC
Active
Other names
Austin Community Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANDERSEN (OWNER)
(503) 704-1485
Entity
Organization
Contact information
Practice address
67 01 AUSTIN ST, FOREST HILLS, NY 11375
(718) 459-0090
(718) 459-8090
Mailing address
6025 JEAN RD, LAKE OSWEGO, OR 97035-5307
(503) 704-1485
(503) 344-4994
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
32632
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146833
PK
—
Enumeration date
02/06/2014
Last updated
07/18/2014
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