Custom Pharmacy Innovations Inc
LBN: Custom Pharmacy Innovations Inc
Custom Pharmacy Innovations Inc is an health care organization with primary practice located at 10911 Ne 23Rd , Nicoma Park OK 73066. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Custom Pharmacy Innovations Inc can be contacted via phone (405) 769-8585, or through Blomgren, John via phone (405) 769-8585.
Contact Information
Primary practice address
10911 Ne 23Rd
Nicoma Park OK 73066
Phone: (405) 769-8585
Fax: (405) 769-8787
Website:
Authorized official contact:
Name: Blomgren, John Doctor of Public Health (DPH)
Phone: (405) 769-8585
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 18135 | Oklahoma |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1073606240 |
|---|---|
| LBN Legal business name | Custom Pharmacy Innovations Inc |
| DBA Doing business as | |
| Authorized official | Blomgren, John Doctor of Public Health (DPH) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Apr 24th, 2018 - about 8 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 | 1073606240 | NPPES |
| Other | 2077070 | PK | |
| MEDICAID | 200095530A | PK |
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