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COMPOUNDING PHARMACY LLC
NPI 1659058733
Pharmacy in Bristol, TN

Active since June 30, 2023CLIA 44D1075251 · Waiver
310 BLUFF CITY HWY, BRISTOL, TN 37620(423) 764-4136(423) 764-5167 Get Directions Write a Review

NPPES record last updated: June 30, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Compounding Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COMPOUNDING PHARMACY LLC (NPI 1659058733) is a healthcare organization registered as a pharmacy in Bristol, Tennessee and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through October 15, 2027 and lists Wesley Vernon Arthur Waters, Owner, as its authorized official.

NPPES Registry Identity

NPI1659058733
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameCOMPOUNDING PHARMACY LLC
Location Address310 BLUFF CITY HWYBristol, TN 37620-4602
Mailing AddressPo Box 305Damascus, VA 24236-0305 · (406) 531-5888
Phone(423) 764-4136
Fax(423) 764-5167
Organization SubpartNo
Authorized OfficialWesley Vernon Arthur WatersOwner · (406) 531-5888
Enumeration DateJune 30, 2023
NPPES CertifiedJune 30, 2023
✔ NPI 1659058733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
310 BLUFF CITY HWY, Bristol, TN 37620
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D1075251

Compounding Pharmacy, The Dba Waters Wellness · Bristol, TN
Active · expires Oct 15, 2027
CLIA Number44D1075251
Laboratory TypePharmacy
Certificate Effective DateOctober 16, 2025
Certificate Expiration DateOctober 15, 2027
Laboratory DirectorPaul Nelson III
Laboratory Phone(423) 764-4136
Laboratory LocationCompounding Pharmacy, The Dba Waters Wellness310 Bluff City Highway, Bristol, TN 37620
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDERSON COMPOUNDING PHARMACY INC
Pharmacy (Compounding Pharmacy)
310 BLUFF CITY HWY
BRISTOL, TN 37620
Sullivan County (423) 764-4136
HOLLIE JOHNSON GAGNE PHARMD
Pharmacist
310 BLUFF CITY HWY
BRISTOL, TN 37620
Sullivan County (423) 764-4136
COMPOUNDING PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
310 BLUFF CITY HWY
BRISTOL, TN 37620
Sullivan County (423) 764-4136

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Compounding Pharmacy LLC's NPI number?

The NPI number for Compounding Pharmacy LLC is 1659058733. It was assigned to this organization in the NPPES registry on June 30, 2023.

Where is Compounding Pharmacy LLC located?

Compounding Pharmacy LLC is located at 310 Bluff City Hwy, Bristol, TN 37620. The listed phone number is (423) 764-4136.

What is Compounding Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Compounding Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D1075251) is associated with this NPI, valid through October 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Compounding Pharmacy LLC was last updated on June 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.