Customedica Pharmacy, Inc in Eagle - Community/retail Pharmacy
Customedica Pharmacy, Inc - NPI 1780729988
Customedica Pharmacy, Inc is a Community/retail Pharmacy in Eagle, Idaho. Customedica Pharmacy, Inc practices all healthcare services and medical treatments related to Community/retail Pharmacy. The NPI Number for Customedica Pharmacy, Inc is 1780729988. The last update date is 2023-03-07.
Customedica Pharmacy, Inc's current location address is 149 W State St, Eagle, Idaho. You can contact this provider via phone number 2089398008 and fax number 2089381067. The mailing address for Customedica Pharmacy, Inc is 149 W State St, Eagle, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Customedica Pharmacy, Inc |
|---|---|
| Address | 149 W State St, Eagle, Idaho |
| Phone Number | 2089398008 |
| Fax Number | 2089381067 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER, PHA |
|---|---|
| Authorized Official Name | Afshar Shah |
| Credentials | RPH |
| Telephone Number | 2089398008 |
NPI Number Detail
| NPI Number | 1780729988 |
|---|---|
| Provider Enumeration Date | 2007-02-21 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 149 W State St |
|---|---|
| City | Eagle |
| State | Idaho (ID) |
| Post Code | 836164959 |
| Phone Number | 2089398008 |
| Fax Number | 2089381067 |
Provider's Primary Taxonomy Detail
| Speciality | Community/retail Pharmacy |
|---|---|
| Taxonomy | 3336C0003X |
| Licence No | 1651CP |
|
Definition: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing pr |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1651CP | ID | STATE LICENSE # | |
| 806251800 | ID | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Customedica Pharmacy, Inc by the Centers for Medicare & Medicaid Services (CMS)?
The Customedica Pharmacy, Inc has been assigned the NPI (National Provider Identifier) 1780729988. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Customedica Pharmacy, Inc is physically located?
The Customedica Pharmacy, Inc is physically situated at the following address: 149 W State St, Eagle, ID, 836164959.
What is Customedica Pharmacy, Inc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Customedica Pharmacy, Inc is Community/retail Pharmacy, and the taxonomy code that classifies this field of practice is 3336C0003X.
When was the Customedica Pharmacy, Inc's 1780729988 issued?
The Customedica Pharmacy, Inc's 1780729988 was issued on 2007-02-21.
When was the information regarding Customedica Pharmacy, Inc most recently updated?
The details pertaining to the Customedica Pharmacy, Inc, including its address, specialty, and other relevant information, were last refreshed on 2023-03-07.
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