National Provider Identifier Database

CUSTOM HEALTH PHARMACY INC
Compounding Pharmacy

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner?s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.


Contact Information

CUSTOM HEALTH PHARMACY INC
844 WILLARD DR STE 7
GREEN BAY, WI54304-5265
Phone: 920-884-7345
Fax: 920-884-7346
Website:
Specialty Taxonomy Code
* Compounding Pharmacy 3336C0004X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for CUSTOM HEALTH PHARMACY INC

NPI Number 1104088020
Legal business name
LBN
CUSTOM HEALTH PHARMACY INC
Authorized official JOHN SOWINSKI - (PHARMACIST/PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 07/01/2008
Last updated 05/16/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 9354-42
  • Other: 2133536 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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