Provider Demographics
NPI:1336330406
Name:APOTHECARY COMPOUNDING SOLUTIONS INC
Entity Type:Organization
Organization Name:APOTHECARY COMPOUNDING SOLUTIONS INC
Other - Org Name:APOTHECARY COMPOUNDING SOLUTIONS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MURDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-248-9065
Mailing Address - Street 1:3909 CREEKSIDE LOOP
Mailing Address - Street 2:STE 110
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-4880
Mailing Address - Country:US
Mailing Address - Phone:509-248-9065
Mailing Address - Fax:509-457-2726
Practice Address - Street 1:3909 CREEKSIDE LOOP
Practice Address - Street 2:STE 110
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4880
Practice Address - Country:US
Practice Address - Phone:509-248-9065
Practice Address - Fax:509-457-2726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
WAPHAR.CF.000590593336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2109095OtherPK