Organization
INTRATHECAL COMPOUNDING SPECIALISTS LLC
Active
Other names
INTRATHECAL COMPOUNDING SPECIALISTS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STUART BURGESS RPH (DIR OF PHARMACY)
(337) 237-6077
Entity
Organization
Contact information
Practice address
206 A JACOBS RUN, SCOTT, LA 70583
(337) 237-6077
(337) 237-8841
Mailing address
206 A JACOBS RUN, SCOTT, LA 70583
(337) 237-6077
(337) 237-8841
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5856
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035607
PK
—
Enumeration date
02/19/2008
Last updated
12/09/2013
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