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MEDFORD COMPOUNDING & SPECIALTY PHARMACY LLC
NPI 1669721239
Pharmacy - Compounding Pharmacy in Medford, NY

Active since August 29, 2012
2612 ROUTE 112, MEDFORD, NY 11763(631) 693-1403(631) 654-1508 Get Directions Write a Review

NPPES record last updated: April 4, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Medford Compounding & Specialty Pharmacy Llc NPPES

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

MEDFORD COMPOUNDING & SPECIALTY PHARMACY LLC (NPI 1669721239) is a healthcare organization registered as a compounding pharmacy in Medford, New York and active in the NPI registry since August 2012. The organization lists Crystal Koller, Vpf, as its authorized official.

NPPES Registry Identity

NPI1669721239
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameMEDFORD COMPOUNDING & SPECIALTY PHARMACY LLC
Location Address2612 ROUTE 112Medford, NY 11763-2522
Mailing Address2608 Route 112Medford, NY 11763-2551 · (631) 475-4141 · Fax (631) 475-4911
Phone(631) 693-1403
Fax(631) 654-1508
Organization SubpartNo
Authorized OfficialCrystal KollerVpf · (631) 475-4141
Enumeration DateAugust 29, 2012
Last NPPES UpdateApril 4, 2017
✔ NPI 1669721239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License✔ Licensed in NY · 031387
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Also ListedPharmacyTaxonomy 333600000X
2612 ROUTE 112, Medford, NY 11763
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Other Names 1

Doing Business AsMedford Compounding & Specialty Pharmacy Llc

Other Identifiers 1

Other2136843Pk

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 Medford Compounding & Specialty Pharmacy LLC's NPI number?

The NPI number for Medford Compounding & Specialty Pharmacy LLC is 1669721239. It was assigned to this organization in the NPPES registry on August 29, 2012.

Where is Medford Compounding & Specialty Pharmacy LLC located?

Medford Compounding & Specialty Pharmacy LLC is located at 2612 Route 112, Medford, NY 11763. The listed phone number is (631) 693-1403.

What is Medford Compounding & Specialty Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

When was this NPI record last updated?

The NPPES record for Medford Compounding & Specialty Pharmacy LLC was last updated on April 4, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.