Provider Demographics
NPI:1750680443
Name:STARR COMPOUNDING PHARMACY
Entity Type:Organization
Organization Name:STARR COMPOUNDING PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:E
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:484-480-3217
Mailing Address - Street 1:24 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MARCUS HOOK
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4515
Mailing Address - Country:US
Mailing Address - Phone:484-480-3217
Mailing Address - Fax:484-480-3234
Practice Address - Street 1:24 E 10TH ST
Practice Address - Street 2:
Practice Address - City:MARCUS HOOK
Practice Address - State:PA
Practice Address - Zip Code:19061-4515
Practice Address - Country:US
Practice Address - Phone:484-480-3217
Practice Address - Fax:484-480-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4819993336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy