Provider Demographics
NPI:1902841133
Name:MEASURED DOSE PHARMACY INC
Entity Type:Organization
Organization Name:MEASURED DOSE PHARMACY INC
Other - Org Name:THE COMPOUNDING PHARMACY INFUSION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MIXON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH MS
Authorized Official - Phone:828-322-9365
Mailing Address - Street 1:750 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-3401
Mailing Address - Country:US
Mailing Address - Phone:828-322-9365
Mailing Address - Fax:828-322-7299
Practice Address - Street 1:750 4TH ST SW
Practice Address - Street 2:STE B
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-3401
Practice Address - Country:US
Practice Address - Phone:828-322-9365
Practice Address - Fax:828-322-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC064563336L0003X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2071314OtherPK
NC0186056Medicaid
NC0186056Medicaid
NC7703313Medicaid