Provider Demographics
NPI:1629635479
Name:MEDSCRIPT COMPOUNDING LLC
Entity Type:Organization
Organization Name:MEDSCRIPT COMPOUNDING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DINO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:888-660-6715
Mailing Address - Street 1:14450 GETZ RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3303
Mailing Address - Country:US
Mailing Address - Phone:888-660-6715
Mailing Address - Fax:844-636-1435
Practice Address - Street 1:14450 GETZ RD STE 200
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3303
Practice Address - Country:US
Practice Address - Phone:888-660-6715
Practice Address - Fax:844-636-1435
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D&D PHARMA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy