Medford Compounding & Specialty Pharmacy LLC
NPI 1669721239ActiveOrganization· Pharmacy, Compounding Pharmacy· Medford, NY
Pharmacy, Compounding Pharmacy in Medford, New York, registered in NPPES in August 2012. The authorized official on file is Crystal Koller, Vpf.
Overview
| NPI | 1669721239 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 29, 2012 |
| Last updated in NPPES | Apr 4, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy, Compounding Pharmacy Primary | 3336C0004X | 031387 | NY |
| Pharmacy | 333600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|