Provider Demographics
NPI:1043503915
Name:COMPOUNDING PHARMACY SOLUTIONS
Entity type:Organization
Organization Name:COMPOUNDING PHARMACY SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDALLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RASSY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-783-2836
Mailing Address - Street 1:6105 BEVERLY HILL STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-6716
Mailing Address - Country:US
Mailing Address - Phone:713-783-2836
Mailing Address - Fax:713-782-2644
Practice Address - Street 1:6105 BEVERLY HILL STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-6716
Practice Address - Country:US
Practice Address - Phone:713-783-2836
Practice Address - Fax:713-782-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
TX274963336C0004X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5903249OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX6686830001Medicare NSC