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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