OrganizationActive
Mack Bayou Pharmacy LLC
NPI 1508112889 · Compounding Pharmacy · Santa Rosa Beach, FL
Provider details
- NPI number
- 1508112889
- Entity type
- Organization
- Primary specialty
- Compounding PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Amy Frazier, Owner(850) 622-0730
Specialties & taxonomies
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
- Pharmacy333600000X
Suppliers
Practice location
82 Mack Bayou Loop Ste B
Santa Rosa Beach, FL 32459-2607
Phone: (850) 622-0730
Fax: (850) 622-0755
Approximate (ZIP-level) locationGet directions
Mailing address
82 Mack Bayou Loop Ste B
Santa Rosa Beach, FL 32459-2607
Other names (DBA / former)
- Doing business as
- Mack Bayou Pharmacy LLC
Registry dates
- Enumerated
- 2012-07-24
- Last updated
- 2017-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.