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:
Health care specialties
| Specialty | Code | License # | 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 2 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 | 1811091879 | NPPES |
| Other | 2027079 | PK | |
| MEDICAID | 100445230C | PK |
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