Provider Demographics
NPI:1962176032
Name:A & J COMPOUNDING INC
Entity type:Organization
Organization Name:A & J COMPOUNDING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-893-3870
Mailing Address - Street 1:577 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-5527
Mailing Address - Country:US
Mailing Address - Phone:781-893-3870
Mailing Address - Fax:
Practice Address - Street 1:577 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-5527
Practice Address - Country:US
Practice Address - Phone:781-893-3870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A & J COMPOUNDING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty