Custom Rx Llc

LBN: Custom Rx Llc
Custom Rx Llc is an health care organization with primary practice located at 112 4Th St , Melba ID 83641-5197. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Custom Rx Llc can be contacted via phone (208) 495-9809, or through Walthall, Travis via phone (208) 922-4400.

Contact Information

Primary practice address
112 4Th St Melba ID 83641-5197
Phone: (208) 495-9809
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Walthall, Travis RPH
Phone: (208) 922-4400

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1477029577
LBN Legal business name Custom Rx Llc
DBA Doing business as
Authorized official Walthall, Travis RPH
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 17th, 2018
Last updated Oct 17th, 2018 - about 7 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.

Request for update

Popular Providers