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A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1912739590 |
| LBN Legal business name | CUSTOM PRESCRIPTION SHOPPE LLC |
| Authorized official | KEVIN FARIS - (CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/14/2024 |
| Last updated | 08/14/2024 - More than a year ago |
| Identifiers | n/a |
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CUSTOM PRESCRIPTION SHOPPE LLC