Organization
COMPOUNDER, LLC
Active
Other names
VitaScript Pharmacy & Nutrition Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH LYNN SHUMAKE JR. PHARMACY DOCTOR (PHARMACIST)
(888) 248-3266
Entity
Organization
Contact information
Practice address
6345 WOODSIDE COURT #102, COLUMBIA, MD 21046-3224
(410) 309-7926
(410) 309-5956
Mailing address
6345 WOODSIDE CT STE 102, SUITE #102, COLUMBIA, MD 21046-3224
(410) 309-7926
(410) 309-5956
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PW0213
MD
3336C0003X
Community/Retail Pharmacy
PW0213
MD
3336C0004X
Compounding Pharmacy
Primary
PW0213
MD
Other
Enumeration date
04/06/2012
Last updated
06/04/2015
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