PROFESSIONAL COMPOUNDING OF ROSWELL INC (NPI# 1689714552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689714552 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL COMPOUNDING OF ROSWELL INC |
| Other Organization Name | PROFESSIONAL COMPOUNDING OF ROSWELL INC |
| Practice Address |
700 N Union Ave Roswell NM 88201-3956 |
| Practice Telephone | 5756226578 |
| Practice Fax Number | 5756233801 |
| Mailing Telephone | 5756226578 |
| Mailing Fax Number | 5756233801 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2015-08-31 |
| Authorized Official Name | CHARLES SHANNON (PRESIDENT) |
| Authorized Official Telephone | 5756226578 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH00002305 | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2058933 | 01 |
| Other Name | Type Code |
|---|---|
| PROFESSIONAL COMPOUNDING OF ROSWELL INC | Doing Business As Name - Organization |
| Street Address |
700 N UNION AVE |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201-3956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861975088 | Cvs Pharmacy Inc | Pharmacy | 700 N Union Ave, Roswell, NM 88201-3956 | 2018-09-13 |
| 1578049532 | Lindsey Grace Pearce | Pharmacist | 700 N Union Ave, Roswell, NM 88201-3956 | 2018-07-12 |
| 1952539595 | Brian L Doyle | Pharmacist | 700 N Union Ave, Roswell, NM 88201-3956 | 2009-06-22 |
| 1902021272 | R & S Drug Corporation | Pharmacy | 700 N Union Ave, Roswell, NM 88201-3956 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740559913 | Aom Pharmacy Advanced Orthomolecular Medicine | Pharmacy | 4514 Central Ave Se, Se, Albuquerque, NM 87108-1212 | 2011-12-18 |
| 1013216027 | Rx Express Pharmacy | Pharmacy | 8900 Menaul Ne, Albuquerque, NM 87112-8700 | 2011-03-17 |
| 1679891238 | Portales Professional Compounding LLC | Pharmacy | 1719 S. Ave D, Portales, NM 88130 | 2010-05-06 |
| 1649311374 | Michael Rayburn | Pharmacy | 123 W Avenue A, Lovington, NM 88260-4211 | 2007-02-08 |
| 1497825970 | Duran Central Pharmacy, Inc. | Pharmacy | 1815 Central Ave Nw, Albuquerque, NM 87104-1143 | 2006-11-09 |
| 1386655934 | Fmc Pharmacy Inc | Pharmacy | 1676 Hospital Dr, Santa Fe, NM 87505-4754 | 2006-08-10 |
| 1417945494 | Pharmacy Capital LLC | Pharmacy | 717 Encino Pl Ne, Ste 1, Albuquerque, NM 87102-2611 | 2005-10-12 |
| 1245688407 | Crlkemper | Pharmacy | 312 N California St, Socorro, NM 87801-4207 | 2016-05-28 |
| 1740549054 | Sierra Blanca Pharmacy LLC | Pharmacy | 1206 Mechem Dr, Ruidoso, NM 88345-7206 | 2012-05-07 |
| 1285924803 | Complete Care Pharmacy LLC | Pharmacy | 4940 Corrales Rd, Suite 200, Corrales, NM 87048-8673 | 2011-04-15 |
| Find all providers with the same taxonomy | ||||
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| 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.