Custom Compounding Centers

LBN: Custom Compounding Centers Llc
Custom Compounding Centers is an health care organization with primary practice located at 10525 Humbolt St , Los Alamitos CA 90720-5401. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty. Custom Compounding Centers Llc can be contacted via phone (714) 894-2120, or through Wheeler, Paul via phone (714) 824-2120.

Contact Information

Primary practice address
10525 Humbolt St Los Alamitos CA 90720-5401
Phone: (714) 894-2120
Fax: (714) 894-2150
Website:
Map and Directions
Authorized official contact:
Name: Wheeler, Paul
Phone: (714) 824-2120

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X PHY 50368 California

Profile Details

NPI number 1902128911
LBN Legal business name Custom Compounding Centers Llc
DBA Doing business as Custom Compounding Centers
Authorized official Wheeler, Paul
Entity Organization
Organization subpart 1 No
Enumeration date Feb 17th, 2010
Last updated Jan 14th, 2014 - 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 1902128911 NPPES
Other 0590388 NCPDP PROVIDER IDENTIFICATION NUMBER

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