Provider Demographics
NPI:1013331727
Name:COMPOUND MD INC
Entity Type:Organization
Organization Name:COMPOUND MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-985-8533
Mailing Address - Street 1:10948 N 56TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3001
Mailing Address - Country:US
Mailing Address - Phone:813-985-8533
Mailing Address - Fax:813-436-5523
Practice Address - Street 1:10948 N 56TH ST STE 202
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3001
Practice Address - Country:US
Practice Address - Phone:813-985-8513
Practice Address - Fax:813-792-4780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH272533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy