Provider Demographics
NPI:1154577138
Name:US COMPOUNDING INC.
Entity type:Organization
Organization Name:US COMPOUNDING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:501-327-1222
Mailing Address - Street 1:2515 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6135
Mailing Address - Country:US
Mailing Address - Phone:501-327-1222
Mailing Address - Fax:501-327-2488
Practice Address - Street 1:2515 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6135
Practice Address - Country:US
Practice Address - Phone:501-327-1222
Practice Address - Fax:501-327-2488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR205033336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0422179OtherNCPDP/NABP