INNOVATION COMPOUNDING PHARMACY, LLC
INNOVATION COMPOUNDING PHARMACY, LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1710157342, based in Kennesaw, GA. It is classified under Compounding Pharmacy.
Getting there
The practice address on file is 6095 PINE MOUNTAIN RD NW STE 108, Kennesaw, GA 30152. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| PHRE009149 | GA | Compounding Pharmacy primary |
This provider holds licence PHRE009149 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Mass Immunization (roster Biller Only)
- PAC ID
- 8022420496
- Enrollment ID
- O20201209002689
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Mass Immunization (roster Biller Only). Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Compounding Pharmacy covers
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. NUCC Health Care Provider Taxonomy, code 3336C0004X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 3336C0004X | Compounding Pharmacy Compounding Pharmacy | PHRE009149 | GA | primary |
| 3336C0004X | Compounding Pharmacy Compounding Pharmacy | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1710157342 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Mar 11, 2008 |
| Last updated | Jan 13, 2022 |
| Status | Active |
| Practice address |
6095 PINE MOUNTAIN RD NW STE 108 Kennesaw, GA 30152 (770) 421-1399 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 7 | 1 | 0 | 1 | 5 | 7 | 3 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 2 | 0 | 2 | 5 | 5 | 3 | 8 |
Sum = 58 · next multiple of 10 = 60 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.