Provider Demographics
NPI:1295816387
Name:COMPOUNDING CORNER INC.
Entity Type:Organization
Organization Name:COMPOUNDING CORNER INC.
Other - Org Name:MULLER COMPOUNDING CORNER INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR/PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:BELTHAZAR
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:985-882-6333
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-0217
Mailing Address - Country:US
Mailing Address - Phone:985-882-6333
Mailing Address - Fax:985-882-5307
Practice Address - Street 1:61000 SEVENTEENTH ST.
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-0217
Practice Address - Country:US
Practice Address - Phone:985-882-6333
Practice Address - Fax:985-882-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA45483336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1928398OtherNAPB