Provider Demographics
NPI:1982095238
Name:AGBI'S COMPOUNDING PHARMACY LLC
Entity Type:Organization
Organization Name:AGBI'S COMPOUNDING PHARMACY LLC
Other - Org Name:AGBI'S PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELECHI
Authorized Official - Middle Name:E
Authorized Official - Last Name:AGBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D, CGP, RPH
Authorized Official - Phone:410-206-4179
Mailing Address - Street 1:605 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5100
Mailing Address - Country:US
Mailing Address - Phone:410-415-5370
Mailing Address - Fax:410-484-1652
Practice Address - Street 1:605 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5100
Practice Address - Country:US
Practice Address - Phone:410-415-5370
Practice Address - Fax:410-484-1652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW04693336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy