Custom Care Pharmacy
LBN: Stl Health Resources Co.
Custom Care Pharmacy is an health care organization with primary practice located at 855 A Ave Ne Ste 110 , Cedar Rapids IA 52402-5060. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Stl Health Resources Co. can be contacted via phone (319) 369-7403, or through Havel, Jessica K via phone (319) 369-7403.
Contact Information
Primary practice address
855 A Ave Ne Ste 110
Cedar Rapids IA 52402-5060
Phone: (319) 369-7403
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 1321 | Iowa |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 1321 | Iowa |
Profile Details
| NPI number | 1427268655 |
|---|---|
| LBN Legal business name | Stl Health Resources Co. |
| DBA Doing business as | Custom Care Pharmacy |
| Authorized official | Havel, Jessica K PHARMD |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | May 23rd, 2007 |
| Last updated | Nov 3rd, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427268655 | NPPES |
| Iowa | Other | 0432090010 | MEDICARE DME SUPPLIER |
| Iowa | Other | I20972 | MEDICARE DME SUPPLIER |
| Iowa | MEDICAID | 1427268655 | MEDICARE DME SUPPLIER |
| Iowa | Other | 1623051 | MEDICARE DME SUPPLIER |
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