NPI 1174009732 · live from the CMS NPI Registry
Direct Compounding And Outsourcing
Pharmacy, Compounding Pharmacy in Henderson, NV. National Provider Identifier 1174009732, active.
NPI record
| NPI | 1174009732 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Compounding Pharmacy 3336C0004X |
| Practice location | 1850 Whitney Mesa Dr Ste 180, Henderson, NV 89014 |
| Practice phone | 702-877-0703 |
| Enumerated | July 17, 2018 |
| Last updated | July 17, 2018 |
| Authorized official | Ellie Gerber, Manager |
| Other names | Direct Compounding |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy, Compounding Pharmacy primary | 3336C0004X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.