American Custom Compounding Pharmacy

NPI 1114266889 - Pharmacy - 3336C0004X

NPI Details
NPI 1114266889
Enumeration Date 01/31/2013
Last Updated 01/31/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name MATT MATT
Position OWNER
Phone (214) 366-0022
Fax (214) 366-0298
Practice Location
2607 WALNUT HILL LN
SUITE 220
DALLAS TX, 75229-5638, US
Phone (214) 366-0022
Fax (214) 366-0298
Business Location
2607 WALNUT HILL LN
SUITE 220
DALLAS TX, 75229-5638, US
Phone (214) 366-0022
Fax (214) 366-0298
Toxanomy
Taxonomy Code 3336C0004X
License State Texas
License Number 27976
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According to our database, American Custom Compounding Pharmacy NPI is 1114266889, taxonomy code is 3336C0004X and license number is 27976, license state is located at Texas. American Custom Compounding Pharmacy physically located at 2607 Walnut Hill Ln, Dallas TX, 75229-5638. NPI Number 1033115704 has the healthcare provider type.

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1114266889 NPI number is provided on an as is basis without warranty of any kind. 1114266889 is maintained by the National Plan & Provider Enumeration System. The contents of American Custom Compounding Pharmacy are for informational purposes only.