Organization
PHARMACEUTICAL COMPOUNDING SPECIALISTS OF WYOMING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD L JOHNSON (OWNER)
(307) 472-0597
Entity
Organization
Contact information
Practice address
2546 E 2ND ST, BLDG#100, CASPER, WY 82609-2062
(307) 472-0597
(307) 237-7748
Mailing address
2546 E 2ND ST, BLDG#100, CASPER, WY 82609-2062
(307) 472-0597
(307) 237-7748
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5282609A
WY
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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