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Provider record
Mack Bayou Pharmacy LLC
Use this page to review the CMS NPPES listing for Mack Bayou Pharmacy LLC: Compounding Pharmacy, organization entity type, practice location in Santa Rosa Beach, FL, and source checked date. Confirm details directly with the provider.
NPI1508112889
Entity typeOrganization
Reported phone(850) 622-0730
SourceCMS NPPES
National Plan and Provider Enumeration System
Source checkedJune 28, 2026
Data pulled and checked
NPPES statusActive
Reported to NPPES
Directory statusIndependent
No affiliation or endorsement implied
We show source-reported CMS NPPES fields.
Confirm details directly with the provider.NPI and status
Source-labeled identifiers and reported record state.
- NPI
- 1508112889
- Entity type
- Organization
- NPPES status
- Reported active
- License status
- Not primary-source verified
Practice location
Practice address and phone as reported in CMS NPPES.
- Address
- 82 Mack Bayou Loop Ste B
Santa Rosa Beach, FL 32459-2607 - Phone
- (850) 622-0730
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Directions
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How to verify this record
Use this page as a starting point, then confirm details from primary or direct sources.
- Confirm the office address and phone number directly with the provider.
- Use the NPI number when comparing this record with CMS NPPES.
- Check state licensing sources separately for license status or disciplinary history.
- Ask the office about insurance, appointments, services, and availability.
Taxonomy and source
Specialty taxonomy is source-reported and not a quality or license determination.
- Taxonomy code
- 3336C0004X
- Specialty
- Compounding Pharmacy
- Source
- CMS NPPES
- Last updated
- June 7, 2026