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Organization

MADISON MEDICAL COMPOUNDING PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTEN LEANN CHAMBERS PHARM.D. (PHARMACIST IN CHARGE)
(662) 820-4305
Entity
Organization

Contact information

Practice address
111 FOUNTAINS BLVD. BUILDING B STE. A, MADISON, MS 39110
(601) 707-7545
Mailing address
111 FOUNTAINS BLVD. BUILDING B STE. A, MADISON, MS 39110
(601) 707-7545

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
17118
MS
3336S0011X
Specialty Pharmacy
17118
MS

Other

Enumeration date
08/24/2018
Last updated
03/07/2023
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