Provider Demographics
NPI:1922628064
Name:COMPOUNDING DOCS, INC
Entity Type:Organization
Organization Name:COMPOUNDING DOCS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CMS, RPHT
Authorized Official - Phone:561-572-1944
Mailing Address - Street 1:1000 CLINT MOORE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2807
Mailing Address - Country:US
Mailing Address - Phone:561-826-0711
Mailing Address - Fax:888-400-9810
Practice Address - Street 1:1000 CLINT MOORE RD STE 201
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2807
Practice Address - Country:US
Practice Address - Phone:561-826-0711
Practice Address - Fax:888-400-9810
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPOUNDING DOCS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-18
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center