Provider Demographics
NPI:1376188516
Name:DANVILLE COMPOUNDING CENTER
Entity Type:Organization
Organization Name:DANVILLE COMPOUNDING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-238-7282
Mailing Address - Street 1:900 HUSTONVILLE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2137
Mailing Address - Country:US
Mailing Address - Phone:859-238-7282
Mailing Address - Fax:859-936-2043
Practice Address - Street 1:900 HUSTONVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2137
Practice Address - Country:US
Practice Address - Phone:859-238-7282
Practice Address - Fax:859-936-2043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy