Medford Compounding & Specialty Pharmacy Llc
Compounding Pharmacy
2612 Route 112, Medford
New York, 11763-2522
631-693-1403 631-654-1508
Medford Compounding & Specialty Pharmacy Llc is a Compounding Pharmacy in Medford, New York. It is located at 2612 Route 112, Medford and it's customer support contact number is 631-693-1403. The authorized person of Medford Compounding & Specialty Pharmacy Llc is Crystal Koller who is Vpf of the pharmacy and his contact number is 631-475-4141. Active license number of Medford Compounding & Specialty Pharmacy Llc is 031387 for Compounding Pharmacy in New York.
Medford Compounding & Specialty Pharmacy Llc is 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.
Pharmacy Details:
Medford Compounding & Specialty Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Medford Compounding & Specialty Pharmacy Llc |
| Type: | Compounding Pharmacy |
| Location: | 2612 Route 112, Medford,
New York, 11763-2522 |
| Phone: | 631-693-1403 |
| Fax: | 631-654-1508 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Crystal Koller |
| Position: | Vpf |
| Contact Number: | 631-475-4141 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1669721239 |
| NPI Enumeration Date: | 29 Aug, 2012 |
| NPI Last Update On: | 04 Apr, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Medford Compounding & Specialty Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Compounding Pharmacy | 031387 | New York | Primary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2136843 | Other | | Pk |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2608 Route 112,
Medford, New York |
| Zip: | 11763-2551 |
| Phone Number: | 631-475-4141 |
| Fax Number: | 631-475-4911 |
Patients can reach Medford Compounding & Specialty Pharmacy Llc at
2612 Route 112, Medford, New York or can
call on customer care at 631-693-1403.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.