Custom Prescription Shoppe

LBN: Duramed Healthcare Inc
Custom Prescription Shoppe is an health care organization with primary practice located at 1543 15 Street , Augusta GA 30901. The organization recently has only one registered license in Suppliers / Compounding Pharmacy, which is considered as the primary health care specialty. Duramed Healthcare Inc can be contacted via phone (706) 737-3955, or through Holgate, Eric via phone (706) 737-3955.

Contact Information

Primary practice address
1543 15 Street Augusta GA 30901
Phone: (706) 737-3955
Fax: (706) 737-6323
Website:
Map and Directions
Authorized official contact:
Name: Holgate, Eric
Phone: (706) 737-3955

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Compounding Pharmacy 3336C0004X PHRE007052 Georgia

Profile Details

NPI number 1053370932
LBN Legal business name Duramed Healthcare Inc
DBA Doing business as Custom Prescription Shoppe
Authorized official Holgate, Eric
Entity Organization
Organization subpart 1 No
Enumeration date Mar 21st, 2006
Last updated Dec 30th, 2013 - about 13 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 1053370932 NPPES
Georgia MEDICAID 000398461A

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