Provider Demographics
NPI:1962681007
Name:R & R COMPOUNDING PHARMACY LLC
Entity Type:Organization
Organization Name:R & R COMPOUNDING PHARMACY LLC
Other - Org Name:TALON COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-424-0025
Mailing Address - Street 1:2950 THOUSAND OAKS DR
Mailing Address - Street 2:SUITE 25
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3361
Mailing Address - Country:US
Mailing Address - Phone:210-424-0025
Mailing Address - Fax:210-424-0026
Practice Address - Street 1:2950 THOUSAND OAKS DR
Practice Address - Street 2:SUITE 25
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3361
Practice Address - Country:US
Practice Address - Phone:210-424-0025
Practice Address - Fax:210-424-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22267333600000X, 3336C0004X, 3336C0004X
3336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160643OtherPK