CUSTOM COMPOUNDING PHARMACY LLC


Address: 3816 Ringgold Rd, Chattanooga, TN 37412-1640
Phone: 4236290353

CUSTOM COMPOUNDING PHARMACY LLC (NPI# 1417095407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417095407
Entity Type Organization
Organization Name CUSTOM COMPOUNDING PHARMACY LLC
Other Organization Name CUSTOM COMPOUNDING PHY LLC
Practice Address 3816 Ringgold Rd
Chattanooga
TN 37412-1640
Practice Telephone 4236290353
Practice Fax Number 4236299646
Enumeration Date 2007-02-02
Last Update Date 2007-07-20
Authorized Official Name JOE MUSICK (PHARMACIST)
Authorized Official Telephone 4236290353
Authorized Official Credential RPH
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers
N 3336C0004X Pharmacy
Specialization: Compounding Pharmacy
Suppliers
N 333600000X Pharmacy Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
0000003295 TN Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
OTHER ID NUMBER 4432061 01
OTHER ID NUMBER-COMMERCIAL NUMBER 4432061 01

Other Provider/Organization Names

Other Name Type Code
CUSTOM COMPOUNDING PHY LLC Doing Business As Name - Organization

Office Location

Street Address 3816 RINGGOLD RD
City CHATTANOOGA
State TN
Zip Code 37412-1640

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316482458 East Ridge Snf Operations, LLC Skilled Nursing Facility 1502 Mcdonald Rd., East Ridge, TN 37412 2016-12-28
1487080149 Puckett Med Van LLC Non-emergency Medical Transport (VAN) 5603 Ringgold Road, East Ridge, TN 37412 2013-09-25
1538420229 Nathan Hartgrove Internal Medicine 961 Spring Creek Rd Ste 300, Chattanooga, TN 37412 2012-05-30
1770869042 Jonathan Bailey Barnett I Pharmacist 5301 Ringold Rd, East Ridge, TN 37412 2011-10-31
1932482791 Ronald P Leonard Pharmacist 7354 East Brainerd Rd, Chattanooga, TN 37412 2011-09-27
1164758561 Zoilus, Inc Home Health 912 Belvoir Hills Circle, Chattanooga, TN 37412 2009-10-20
1093935157 Alan L Crisman Dentist 1421 Armour Street, Chattanooga, TN 37412 2007-04-30
1700949989 Keith Brian Sparkman Optometrist 1013 Spring Creek Rd, Chattanooga, TN 37412 2006-12-18
1174617161 Shahul H Majeed Obstetrics & Gynecology 1012 Spring Creek Road, Chattanooga, TN 37412 2006-10-03
1356434070 Mckinley Snipes Lundy Sr. Preventive Medicine 931 Spring Creek Road, Suite 200, Chattanooga, TN 37412 2006-10-02
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Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811522485 On Site Rx Inc Pharmacy 3074 Hickory Valley Rd Bldg 229, Chattanooga, TN 37421-1273 2020-03-04
1073170718 A Pharmacy LLC Pharmacy 4767 Hwy 58, Suite 101, Chattanooga, TN 37416 2019-05-28
1982952917 Carestar Pharmacy Pharmacy 6106 Shallowford Rd Ste 108, Chattanooga, TN 37421-2280 2012-08-23
1548584634 Eastside Pharmacy Inc Pharmacy 6857 Lee Hwy, Chattanooga, TN 37421-6406 2010-03-18
1538342076 Ross Enterprise Inc Pharmacy 2001 E Third St Suite C, Chattanooga, TN 37404-2610 2007-12-06
1699831966 Deems S Riddle IIi Pharmacy 4335 Ringgold Rd, Chattanooga, TN 37412-2740 2006-12-29
1952496804 Pulmonaire Service Pharmacy, Inc. Pharmacy 821 Mccallie Ave, Chattanooga, TN 37403-2613 2006-10-04
1215030911 Tennessee Cvs Pharmacy LLC Pharmacy 5501 Brainerd Rd, Chattanooga, TN 37411-5309 2006-09-07
1306949003 Tennessee Cvs Pharmacy LLC Pharmacy 5011 State St # A, Chattanooga, TN 37407-3519 2006-09-07
1073616785 Tennessee Cvs Pharmacy LLC Pharmacy 321 Browns Ferry Rd, Chattanooga, TN 37419-1546 2006-09-07
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Competitor

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City CHATTANOOGA
Zip Code 37412

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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