Provider Demographics
NPI:1336903533
Name:BEAR'S COMPOUNDING PHARMACY LLC
Entity Type:Organization
Organization Name:BEAR'S COMPOUNDING PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-807-0622
Mailing Address - Street 1:109 W 7TH ST STE 115
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-5720
Mailing Address - Country:US
Mailing Address - Phone:512-807-0622
Mailing Address - Fax:512-843-7255
Practice Address - Street 1:109 W 7TH ST STE 115
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-5720
Practice Address - Country:US
Practice Address - Phone:512-807-0622
Practice Address - Fax:512-843-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy