Provider Demographics
NPI:1003130410
Name:HILLS APOTHECARY COMPOUNDING LLC
Entity Type:Organization
Organization Name:HILLS APOTHECARY COMPOUNDING LLC
Other - Org Name:THE COMPOUNDING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:620-342-1661
Mailing Address - Street 1:2715 CANDLEWOOD DR
Mailing Address - Street 2:SUITE A1
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-6653
Mailing Address - Country:US
Mailing Address - Phone:620-342-1661
Mailing Address - Fax:620-342-1663
Practice Address - Street 1:2715 CANDLEWOOD DR
Practice Address - Street 2:SUITE A1
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6653
Practice Address - Country:US
Practice Address - Phone:620-342-1661
Practice Address - Fax:620-342-1663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-099833336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy