Provider Demographics
NPI:1003022203
Name:TOWN & COUNTRY COMPOUNDING AND CONSULTATION SERVICES LLC
Entity Type:Organization
Organization Name:TOWN & COUNTRY COMPOUNDING AND CONSULTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, FIACP, RPIC
Authorized Official - Phone:201-447-2020
Mailing Address - Street 1:535 E CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2922
Mailing Address - Country:US
Mailing Address - Phone:201-447-2020
Mailing Address - Fax:201-447-3253
Practice Address - Street 1:535 E CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2922
Practice Address - Country:US
Practice Address - Phone:201-447-2020
Practice Address - Fax:201-447-3253
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN & COUNTRY COMPOUNDING AND CONSULTATION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-15
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRS006241003336C0004X
NJ28RS006241003336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3145287OtherNCPDP
NJRS00624100OtherSTORE LICENSE
NJ3145287OtherNCPDP
NJ3145287OtherNCPDP