Organization
PHARMACY COMPOUNDING VENTURES
Active
Other names
Custom Compounding Center of Arkansas
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WAYNE SHINABERY RPH (MANAGER.OWNER)
(501) 217-0000
Entity
Organization
Contact information
Practice address
11700 KANIS RD, SUITE1, LITTLE ROCK, AR 72211-3729
(501) 217-0000
Mailing address
11700 KANIS RD, SUITE1, LITTLE ROCK, AR 72211-3729
(501) 217-0000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
AR7501
AR
Other
Enumeration date
02/15/2007
Last updated
01/30/2013
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