Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oxygen Equipment & Supplies |
332BX2000X | B1 | Oxygen supplier |
| NPI Number | 1104227602 |
| LBN Legal business name | CUSTOM SCRIPT PHARMACY |
| Authorized official | JONATHAN BEAVER - (RESPIRATORY THERAPIST) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/16/2014 |
| Last updated | 09/16/2014 - About 12 years ago |
| Identifiers | n/a |
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