Custom Prescription Shoppe Llc

LBN: Custom Prescription Shoppe Llc
Custom Prescription Shoppe Llc is an health care organization with primary practice located at 1313 E Maple St Ste 101, Bellingham WA 98225-5708. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Mail Order Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Custom Prescription Shoppe Llc can be contacted via phone (360) 685-4242, or through Faris, Kevin via phone (360) 685-4242.

Contact Information

Primary practice address
1313 E Maple St Ste 101 Bellingham WA 98225-5708
Fax: (360) 685-4243
Website:
Authorized official contact:
Name: Faris, Kevin RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X CF00057668 Washington
Suppliers / Mail Order Pharmacy 3336M0002X

Profile Details

NPI number 1932288438
LBN Legal business name Custom Prescription Shoppe Llc
DBA Doing business as
Authorized official Faris, Kevin RPH
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2006
Last updated Dec 6th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932288438 NPPES
Other 4930550 OTHER ID NUMBER
MEDICAID 6026835 OTHER ID NUMBER

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