Organization
ISLAND COMPOUNDING PHARMACY LLC
Active
Other names
Stephens Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILHEMINA SMITH FRY PHARM.D. (OWNER/SOLE MEMBER)
(843) 686-3040
Entity
Organization
Contact information
Practice address
55 MATHEWS DR STE 215, HILTON HEAD ISLAND, SC 29926-3731
(843) 686-3040
(843) 686-3035
Mailing address
55 MATHEWS DR STE 215, HILTON HEAD ISLAND, SC 29926-3731
(843) 686-3040
(843) 686-3035
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
16203
SC
Other
Enumeration date
11/25/2015
Last updated
11/25/2015
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