Organization
IVY SPECIALTY COMPOUNDING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE HOBGOOD MD (MANAGER)
(806) 438-3544
Entity
Organization
Contact information
Practice address
2222 INDIANA AVE, LUBBOCK, TX 79410-2100
(806) 209-5140
Mailing address
2222 INDIANA AVE, LUBBOCK, TX 79410-2100
(806) 209-5140
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
12/27/2022
Last updated
12/27/2022
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