Provider Demographics
NPI:1801013909
Name:RC COMPOUNDING SERVICES LLC
Entity Type:Organization
Organization Name:RC COMPOUNDING SERVICES LLC
Other - Org Name:RC COMPOUNDING SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHRM
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-707-9001
Mailing Address - Street 1:3030 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-2158
Mailing Address - Country:US
Mailing Address - Phone:330-707-9001
Mailing Address - Fax:
Practice Address - Street 1:3030 CENTER RD
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-2158
Practice Address - Country:US
Practice Address - Phone:330-707-9001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0216789503336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2080734OtherPK