Organization
COMPOUNDING PHARMACY LLC
Active
Organization
COMPOUNDING PHARMACY LLC
Active
Other names
ANDERSON COMPOUNDING PHARMACY, WATERS WELLNESS
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY WATERS III PHARMD (OWNER/PHARMACIST)
(406) 531-5888
Entity
Organization
Contact information
Practice address
310 BLUFF CITY HWY, BRISTOL, TN 37620-4602
(423) 764-4136
(423) 764-5167
Mailing address
310 BLUFF CITY HWY, BRISTOL, TN 37620-4602
(423) 764-4136
(423) 764-5167
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2113
TN
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445728
—
NC
01
—
4425903
OTHER ID NUMBER
—
05
—
4425903
—
TN
05
—
8508895
—
VA
Enumeration date
05/23/2006
Last updated
01/20/2026
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