Organization
THE COMPOUNDING SHOPPE &FARMACY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID NICHOLAS HOLT (OWNER)
(919) 215-2307
Entity
Organization
Contact information
Practice address
2001 S MAIN ST, WAKE FOREST, NC 27587-1649
(919) 569-0500
(919) 556-4288
Mailing address
2001 S MAIN ST, WAKE FOREST, NC 27587-1649
(919) 569-0500
(919) 556-4288
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
11396
NC
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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