Provider Demographics
NPI:1073866893
Name:CANTRELL COMPOUNDING, INC.
Entity type:Organization
Organization Name:CANTRELL COMPOUNDING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCARLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:PD
Authorized Official - Phone:501-663-3642
Mailing Address - Street 1:7321 CANTRELL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4144
Mailing Address - Country:US
Mailing Address - Phone:501-663-6368
Mailing Address - Fax:501-907-5978
Practice Address - Street 1:7321 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4144
Practice Address - Country:US
Practice Address - Phone:501-663-6368
Practice Address - Fax:501-907-5978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR20682333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy