CREATIVE COMPOUNDING SOLUTIONS LLC


Address: 2803 E State Blvd, Fort Wayne, IN 46805-4732
Phone: 2604833169

CREATIVE COMPOUNDING SOLUTIONS LLC (NPI# 1124170014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124170014
Entity Type Organization
Organization Name CREATIVE COMPOUNDING SOLUTIONS LLC
Other Organization Name MEDICINE CHEST
Practice Address 2803 E State Blvd
Fort Wayne
IN 46805-4732
Practice Telephone 2604833169
Practice Fax Number 2604833160
Mailing Telephone 2604833169
Mailing Fax Number 2604833160
Enumeration Date 2007-01-18
Last Update Date 2018-07-19
Authorized Official Name ANDREW CAMPBELL (OWNER)
Authorized Official Telephone 2604833169
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
N 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers
Y 3336C0004X Pharmacy
Specialization: Compounding Pharmacy
60002334A IN Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2169538 01

Other Provider/Organization Names

Other Name Type Code
Medicine Chest Doing Business As Name - Organization

Office Location

Street Address 2803 E STATE BLVD
City FORT WAYNE
State IN
Zip Code 46805-4732

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871021246 Andrew Campbell Pharmacist 2803 E State Blvd, Fort Wayne, IN 46805-4732 2017-05-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619589546 Connor Gemlick Student in an Organized Health Care Education/Training Program 1918 Carew St., Fort Wayne, IN 46805 2020-08-21
1710464086 S.t.a.r. Care Services Clinic/Center 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 2018-07-19
1083122865 Noel Shafi Counselor 3010 East State Boulevard, Fort Wayne, IN 46805 2018-01-16
1063963627 Toni L Irby Specialist 3219 E State Blvd, Fort Wayne, IN 46805 2016-10-19
1639626211 Logan Schwerer Pharmacist 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 2016-09-01
1063817104 Michale Diane Rothgeb Physical Therapy Assistant 2200 Randollia Dr, Fort Wayne, IN 46805 2014-10-31
1124435789 Julia I. Mcfann Physical Therapist 2200 Randalia Dr, Fort Wayne, IN 46805 2014-07-16
1083036974 Capital Senior Living Properties 4, Inc. Assisted Living Facility 3320 East State Boulevard, Fort Wayne, IN 46805 2014-01-10
1356772396 Alexander James Medical Supply Durable Medical Equipment & Medical Supplies 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 2013-12-02
1043595689 Randy James Jennings Pharmacist 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 2011-10-14
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Taxonomy Information

Taxonomy Code 3336C0004X
Grouping Suppliers
Classification Pharmacy
Specialization Compounding Pharmacy

Taxonomy 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.
Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265795082 Jay Shree Ganesh Inc Pharmacy 10124 Auburn Park Dr, Fort Wayne, IN 46825-2392 2012-06-18
1134493810 North Anthony Pharmacy & Wellness Center Inc Pharmacy 3537 N Anthony Blvd Ste A, Fort Wayne, IN 46805-1423 2012-02-28

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1851934616 Right Med Pharmacy, LLC Pharmacy 303 S Main St Ste 100, Mishawaka, IN 46544-2159 2019-10-24
1023678489 Pure Pharmacy LLC Pharmacy 12425 Old Meridian St Ste B3, Carmel, IN 46032-8725 2019-06-18
1912461468 Pain Management Centers of America Pharmacy 1101 Professional Blvd Ste 212, Evansville, IN 47714-8016 2019-01-29
1538678545 Quality Care Pharmacy, LLC Pharmacy 4708 W Western Ave, South Bend, IN 46619-2306 2017-09-21
1891199295 Anderson Healthcare Inc Pharmacy 350 S Van Buren St Ste F, Shipshewana, IN 46565-9197 2014-10-14
1528479946 Ma Umiya LLC Pharmacy 112 N Randolph St, Garrett, IN 46738-1138 2014-05-20
1831529288 Proscript LLC Pharmacy 9292 N Meridian St Ste 103, Indianapolis, IN 46260-1828 2013-11-22
1699802082 Winona Bldg. Pharmacy, Inc. Pharmacy 3266 N Meridian St Ste 106, Indianapolis, IN 46208-5839 2007-02-27
1720126295 Dekalb Memorial Pharmacare LLC Pharmacy 1314 E 7th St Ste 104, Auburn, IN 46706-2533 2007-02-04
1134206824 Turner Rx Inc Pharmacy 702 Buffaloville Rd, Dale, IN 47523-9693 2006-11-01
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Competitor

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City FORT WAYNE
Zip Code 46805

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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