BRICK CITY COMPOUNDING LLC (NPI# 1316558851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316558851 |
| Entity Type | Organization |
| Organization Name | BRICK CITY COMPOUNDING LLC |
| Practice Address |
159 Fountains Blvd Ste C Madison MS 39110-6344 |
| Practice Telephone | 7692311400 |
| Practice Fax Number | 6018598201 |
| Mailing Telephone | 7692311400 |
| Mailing Fax Number | 6018598201 |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | EDWARD MUSSHAFEN (PHARMACIST-IN-CHARGE) |
| Authorized Official Telephone | 7692311400 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| Street Address |
159 FOUNTAINS BLVD STE C |
| City | MADISON |
| State | MS |
| Zip Code | 39110-6344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407109457 | Keystone Pharmacy LLC | Pharmacy | 106 Highland Way Ste 206, Madison, MS 39110-6930 | 2012-10-15 |
| 1811043870 | Women's International Pharmacy | Pharmacy | 2 Marsh Ct, Madison, WI 53718-8805 | 2007-01-25 |
| 1750673919 | Restore Health Pharmacy, LLC | Pharmacy | 1289 Deming Way, Madison, WI 53717-2007 | 2011-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164968624 | Saver Express LLC | Pharmacy | 1051 Highland Colony Pkwy Ste C, Ridgeland, MS 39157-7701 | 2017-01-09 |
| 1902359342 | Asm Inc | Pharmacy | 9065 Sandidge Center Cv, Suite A, Olive Branch, MS 38654-3574 | 2016-08-02 |
| 1538522446 | Kinetix Group LLC | Pharmacy | 104 Business Park Dr Ste H, Suite H, Ridgeland, MS 39157-6017 | 2016-03-30 |
| 1477968980 | Advantage Apothecary, LLCf | Pharmacy | 5296 Old Highway 11 Ste 4, Hattiesburg, MS 39402-8380 | 2014-06-23 |
| 1275951402 | Olde Towne Drugs, Ltd. | Pharmacy | 1645 W Government Cv Ste E, Brandon, MS 39042-4602 | 2014-04-04 |
| 1992139711 | Midsouth Medical Specialties, LLC | Pharmacy | 185 W Center St, Hernando, MS 38632-2268 | 2013-08-28 |
| 1285987461 | Southwest Pharmacy Inc | Pharmacy | 1005 W Congress St, Brookhaven, MS 39601-2603 | 2012-10-24 |
| 1851648836 | Pharmatex, LLC | Pharmacy | 4551-d Gautier Vancleave Road, Gautier, MS 39553 | 2012-08-09 |
| 1679833404 | Highland Specialty Pharmacy LLC | Pharmacy | 23 Town Center Square, Hattiesburg, MS 39402 | 2012-05-28 |
| 1487806121 | Midsouth Medical Specialties LLC | Pharmacy | 1433 Goodman Rd W, Horn Lake, MS 38637 | 2008-10-14 |
| Find all providers with the same taxonomy | ||||
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| 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.