Provider Demographics
NPI:1285683193
Name:RX COMPOUND CENTRE
Entity Type:Organization
Organization Name:RX COMPOUND CENTRE
Other - Org Name:DELK PHARMACY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER PHARMACIST MGR
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:H
Authorized Official - Last Name:DELK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-388-3999
Mailing Address - Street 1:1515 HATCHER LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401
Mailing Address - Country:US
Mailing Address - Phone:931-388-3999
Mailing Address - Fax:931-380-1917
Practice Address - Street 1:1515 HATCHER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401
Practice Address - Country:US
Practice Address - Phone:931-388-3999
Practice Address - Fax:931-380-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty