Provider Demographics
NPI:1134470362
Name:VARSITY DRUGS & COMPOUNDING, LLC
Entity Type:Organization
Organization Name:VARSITY DRUGS & COMPOUNDING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:WHALEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:615-848-8364
Mailing Address - Street 1:601 VICKERS PL
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3948
Mailing Address - Country:US
Mailing Address - Phone:931-526-8778
Mailing Address - Fax:931-526-8777
Practice Address - Street 1:601 VICKERS PL
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3948
Practice Address - Country:US
Practice Address - Phone:931-526-8778
Practice Address - Fax:931-526-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50643336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy