A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of...
GA license #PHRE009634taxonomy 3336C0004X
Identifiers
Type
Value
Notes
01
2141985
PK
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Coastal Compounding Pharmacy
Type code 3recorded 2013-09-09
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
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