Organization
PREMIUM COMPOUNDING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL BORGHESE (CEO)
(256) 309-7451
Entity
Organization
Contact information
Practice address
3220 HIGHWAY 31 S STE A2, DECATUR, AL 35603-1731
(865) 789-0089
Mailing address
3220 HIGHWAY 31 S STE A2, DECATUR, AL 35603-1731
(865) 789-0089
(256) 685-5138
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
05/28/2026
Last updated
06/03/2026
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