Provider Demographics
NPI:1710616222
Name:AUSTIN COMPOUNDING PHARMACY, LLC
Entity Type:Organization
Organization Name:AUSTIN COMPOUNDING PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:HALISTER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:512-327-7455
Mailing Address - Street 1:3010 BEE CAVES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5526
Mailing Address - Country:US
Mailing Address - Phone:512-327-7455
Mailing Address - Fax:512-327-3025
Practice Address - Street 1:3010 BEE CAVES RD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5526
Practice Address - Country:US
Practice Address - Phone:512-327-7455
Practice Address - Fax:512-327-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy