Organization
BATTLEFIELD COMPOUNDING CENTER INCORPORATED
Active
Other names
Battlefield Compounding Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN STOREY (PRESIDENT)
(601) 642-7050
Entity
Organization
Contact information
Practice address
2080 S FRONTAGE RD, SUITE 101A, VICKSBURG, MS 39180-5328
(601) 636-6693
(601) 638-8446
Mailing address
120 STENSON RD, VICKSBURG, MS 39180-8860
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
08210/02.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2587775
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/21/2009
Last updated
11/03/2009
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