CUSTOM MEDS INC (NPI# 1346209863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346209863 |
| Entity Type | Organization |
| Organization Name | CUSTOM MEDS INC |
| Other Organization Name | CUSTOM MEDS |
| Practice Address |
104 Montgomery St Sw Russellville AL 35653 |
| Practice Telephone | 2563323022 |
| Practice Fax Number | 2563323036 |
| Mailing Telephone | 2563323022 |
| Mailing Fax Number | 2563323036 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TIMOTHY ALAN AARON (PRESIDENT RPH) |
| Authorized Official Telephone | 2563323022 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | Pharmacy Service Providers |
| Other Name | Type Code |
|---|---|
| Custom Meds | Doing Business As Name - Organization |
| Street Address |
104 MONTGOMERY ST SW |
| City | RUSSELLVILLE |
| State | AL |
| Zip Code | 35653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235198730 | The Drug Shop LLC | Pharmacist | 104 Montgomery St Sw, Russellville, AL 35653 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902384720 | Randy Wade Gooch | Pharmacist | 13675 Us-43, Russellville, AL 35653 | 2018-08-02 |
| 1700301470 | Carole Ann Montgomery | Pharmacist | Walmart Pharmacy, 13675 Us-43, Russellville, AL 35653 | 2017-08-03 |
| 1548632755 | Amanda Carrie Franks | Health Educator | 265 Skyline Dr, Russellville, AL 35653 | 2015-10-27 |
| 1023411220 | Wesley Charles Mayfield | Pharmacist | 14001 Hwy 43 Suite 13, Russellville, AL 35653 | 2014-10-01 |
| 1831322841 | Family Health Care Clinic, Inc. | Clinic/Center | 318 Coffee Ave Ne, Russellville, AL 35653 | 2009-08-25 |
| 1538371075 | Eyedocs On Wheels PC | Optometrist | 15255 Hwy 43, Russellville, AL 35653 | 2007-05-04 |
| 1063634574 | Russellville Physician Practices LLC | Orthopaedic Surgery | 715 Gandy Street Ne, Suite B, Russellville, AL 35653 | 2007-05-03 |
| 1750404141 | Alabama Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 14695 Hwy 43, Russellville, AL 35653 | 2007-04-09 |
| 1629111703 | Franklin County Health Dept Offsite Epsdt | Public Health or Welfare | 801 Highway 48, Russellville, AL 35653 | 2007-02-15 |
| 1750457941 | Southern Rural Health Care Consortium, Inc. | Clinic/Center | 318 Coffee Avenue, Russellville, AL 35653 | 2006-11-28 |
| Find all providers in zip 35653 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002782 | Randy Paul Stayton | Pharmacist | 2109 W Main, Russellville, AR 72801 | 2020-10-30 |
| 1356975890 | William John Cobb | Pharmacist | 108 Skyline Dr Ste B, Russellville, AR 72801-3306 | 2020-02-24 |
| 1902384720 | Randy Wade Gooch | Pharmacist | 13675 Us-43, Russellville, AL 35653 | 2018-08-02 |
| 1700301470 | Carole Ann Montgomery | Pharmacist | Walmart Pharmacy, 13675 Us-43, Russellville, AL 35653 | 2017-08-03 |
| 1700260619 | Nikki Jean Scott | Pharmacist | 100 S Knoxville Ave, Russellville, AR 72801-5315 | 2015-07-10 |
| 1023411220 | Wesley Charles Mayfield | Pharmacist | 14001 Hwy 43 Suite 13, Russellville, AL 35653 | 2014-10-01 |
| 1639425911 | Daniel Lee Emery | Pharmacist | 1405 Nashville St Ste A, Russellville, KY 42276-8850 | 2012-07-24 |
| 1518275080 | Dennis E Wheelus | Pharmacist | 3303 W Main Pl, Russellville, AR 72801-2334 | 2010-09-18 |
| 1154647287 | Jimmy Gregory Lane | Pharmacist | 1369 B George Wallace Highway, Russellville, AL 35654 | 2010-04-14 |
| 1083930572 | Jody Kiel | Pharmacist | 15385 Highway 43, Russellville, AL 35653-8061 | 2010-04-09 |
| Find all providers in RUSSELLVILLE | ||||
| City | RUSSELLVILLE |
| Zip Code | 35653 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.