Custom Rx Pharmacy & Wellness Concepts

LBN: Custom Rx Inc
Custom Rx Pharmacy & Wellness Concepts is an health care organization with primary practice located at 3510 N Ridge Rd Ste 900 , Wichita KS 67205-1225. The organization recently has only one registered license in Suppliers / Compounding Pharmacy, which is considered as the primary health care specialty. Custom Rx Inc can be contacted via phone (316) 721-2626, or through Branam, Nicholas L via phone (316) 721-2626.

Contact Information

Primary practice address
3510 N Ridge Rd Ste 900 Wichita KS 67205-1225
Phone: (316) 721-2626
Fax: (316) 721-4823
Website:
Map and Directions
Authorized official contact:
Name: Branam, Nicholas L PHARM.D.
Phone: (316) 721-2626

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Compounding Pharmacy 3336C0004X PH00004390 New Mexico
Suppliers / Compounding Pharmacy 3336C0004X 44645MS Idaho
Suppliers / Compounding Pharmacy 3336C0004X 4477 Iowa
Suppliers / Compounding Pharmacy 3336C0004X 054.019573 Illinois
Suppliers / Compounding Pharmacy 3336C0004X 64001361A Indiana
Suppliers / Compounding Pharmacy 3336C0004X 209867 Kansas
Suppliers / Compounding Pharmacy 3336C0004X OS02495 Arkansas
Suppliers / Compounding Pharmacy 3336C0004X PH17904 Florida
Suppliers / Compounding Pharmacy 3336C0004X 2012019217 Missouri
Suppliers / Compounding Pharmacy 3336C0004X PH02874 Nevada
Suppliers / Compounding Pharmacy 3336C0004X 264830 Minnesota
Suppliers / Compounding Pharmacy 3336C0004X PHNR000914 Georgia
Suppliers / Compounding Pharmacy 3336C0004X PHAR1497 North Dakota
Suppliers / Compounding Pharmacy 3336C0004X 758 Nebraska
Suppliers / Compounding Pharmacy 3336C0004X 13708 North Carolina

Profile Details

NPI number 1811091879
LBN Legal business name Custom Rx Inc
DBA Doing business as Custom Rx Pharmacy & Wellness Concepts
Authorized official Branam, Nicholas L PHARM.D.
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2006
Last updated Jul 12th, 2023 - about 3 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 1811091879 NPPES
Other 2027079 PK
MEDICAID 100445230C PK

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