Provider Demographics
NPI:1285899310
Name:MED SOLUTIONS COMPOUNDING PHARMACY,INC
Entity type:Organization
Organization Name:MED SOLUTIONS COMPOUNDING PHARMACY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HYTHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:336-765-4406
Mailing Address - Street 1:1365 WESTGATE CENTER DR
Mailing Address - Street 2:SUITE F-2
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2980
Mailing Address - Country:US
Mailing Address - Phone:336-765-4406
Mailing Address - Fax:336-765-4489
Practice Address - Street 1:1365 WESTGATE CENTER DR
Practice Address - Street 2:SUITE F-2
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2980
Practice Address - Country:US
Practice Address - Phone:336-765-4406
Practice Address - Fax:336-765-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty