Mack Bayou Pharmacy LLC
NPI #1508112889 in Santa Rosa Beach, Florida
Provider Information
- NPI Number
- 1508112889
- Entity Type
- Organization
- Organization Name
- Mack Bayou Pharmacy LLC
- Primary Specialty
- Pharmacy - Compounding Pharmacy
- Enumeration Date
- Jul 24, 2012
- Last Updated
- Mar 1, 2017
Practice Location
- Address
- 82 MACK BAYOU LOOP STE B
- City
- Santa Rosa Beach
- State
- Florida
- ZIP Code
- 32459-2607
- Phone
- (850) 622-0730
Authorized Official
- Name
- AMY FRAZIER, PHARMD
- Title
- OWNER
- Phone
- (850) 622-0730
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
| Pharmacy |
| Pharmacy - Compounding Pharmacy — Compounding Pharmacy |
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