OrganizationActive
Medford Compounding & Specialty Pharmacy LLC
NPI 1669721239 · Compounding Pharmacy · Medford, NY
Provider details
- NPI number
- 1669721239
- Entity type
- Organization
- Primary specialty
- Compounding PharmacySuppliers
- Authorized official
- Crystal Koller, Vpf
Practice location
2612 Route 112
Medford, NY 11763-2522
Phone: (631) 693-1403
Fax: (631) 654-1508
Mailing address
2608 Route 112
Medford, NY 11763-2551
Registry dates
- Enumerated
- 2012-08-29
- Last updated
- 2017-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.