Organization
SOUTH RIVER COMPOUNDING PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PARKS HORN RPH (PHARMACIST IN CHARGE)
(804) 897-6447
Entity
Organization
Contact information
Practice address
3656 MAYLAND CT, HENRICO, VA 23233-1409
(804) 897-6447
(804) 967-6449
Mailing address
3656 MAYLAND CT, HENRICO, VA 23233-1409
(804) 897-6447
(804) 967-6449
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
07/19/2022
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