<Unavail>

LBN: Custom Compounds Inc
<Unavail> is an health care organization with primary practice located at 400 Gresham Dr , Norfolk VA 23507-1901. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Custom Compounds Inc can be contacted via phone (757) 622-0222, or through Bortoluzzi, Gino via phone (757) 622-0222.

Contact Information

Primary practice address
400 Gresham Dr Norfolk VA 23507-1901
Phone: (757) 622-0222
Fax: (757) 623-9010
Website:
Map and Directions
Authorized official contact:
Name: Bortoluzzi, Gino RPH
Phone: (757) 622-0222

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 0201002286 Virginia
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1447276571
LBN Legal business name Custom Compounds Inc
DBA Doing business as <Unavail>
Authorized official Bortoluzzi, Gino RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2006
Last updated Oct 4th, 2010 - about 16 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 1447276571 NPPES
Other 4808222 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 8515999 NCPDP PROVIDER IDENTIFICATION NUMBER

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