CLASSIC COMPOUNDING PHARMACY, LLC (NPI# 1942830922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942830922 |
| Entity Type | Organization |
| Organization Name | CLASSIC COMPOUNDING PHARMACY, LLC |
| Practice Address |
1171 Us Route 1 York ME 03909-5837 |
| Practice Telephone | 2073519010 |
| Practice Fax Number | 2073519011 |
| Mailing Telephone | 2073519010 |
| Mailing Fax Number | 2073519011 |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2020-01-18 |
| Authorized Official Name | CYNTHIA MARIE THERIAULT (MEMBER/PHARMACIST IN CHARGE) |
| Authorized Official Telephone | 2073519010 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Classic Compounding Pharmacy | Doing Business As Name - Organization |
| Street Address |
1171 US ROUTE 1 |
| City | YORK |
| State | ME |
| Zip Code | 03909-5837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760012744 | Cynthia Marie Theriault | Pharmacist | 1171 Us Route 1, York, ME 03909-5837 | 2020-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588206049 | Kristina Nicole Scangas | Physician Assistant | 3 Loving Kindness Way, York, ME 03909 | 2019-10-16 |
| 1467923540 | St. Georges Childcare Center | Clinic/Center | 407 York Street, York Harbor, ME 03909 | 2018-12-16 |
| 1518398023 | Jm Dental PC | Dentist | 433 F Us Route 1, Suite 107, York, ME 03909 | 2013-12-09 |
| 1043554405 | Jennifer Helen Gustafson | Occupational Therapist | 3 Whittier Way, York, ME 03909 | 2012-11-24 |
| 1720351240 | Kimberly Trafton | Acupuncturist | 272 York Street, York, ME 03909 | 2012-02-14 |
| 1518237767 | Jill Ann Colton-spina | Registered Nurse | 32 York Street, Psychiatry Associates of York Hospital, York, ME 03909 | 2012-01-05 |
| 1497980650 | York Family Dental | Dentist | 433f Us Route 1, Cottage Place Suite 107, York, ME 03909 | 2009-05-18 |
| 1356590947 | Susan A. Emerson | Occupational Therapist | 41 Brixham Rd., York, ME 03909 | 2008-09-18 |
| 1316122252 | John Wendelin Anderer | Dentist | 433 F Us Route 1 Cottage Place John Anderer D.d.s., 107, York, ME 03909 | 2008-01-09 |
| 1720296486 | Town of York/york School Department | Local Education Agency (LEA) | 469 U.S. Route One, York, ME 03909 | 2007-05-18 |
| Find all providers in zip 03909 | ||||
| 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 |
|---|---|---|---|---|
| 1275520686 | Community Pharmacies LLC | Pharmacy | 244 Main St, Saco, ME 04072-1509 | 2005-09-30 |
| 1811255318 | South Berwick Pharmacy Seacoast Compounding Inc. | Pharmacy | 289 Main St, South Berwick, ME 03908-1543 | 2012-05-03 |
| 1225328669 | Moby Rx | Pharmacy | 225 Waterman Dr, South Portland, ME 04106-3634 | 2011-04-19 |
| 1144201377 | West End Drug Company | Pharmacy | 105 Main St, Bar Harbor, ME 04609-1844 | 2005-11-05 |
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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.