CUSTOM COMPOUNDING LLC (NPI# 1376840785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376840785 |
| Entity Type | Organization |
| Organization Name | CUSTOM COMPOUNDING LLC |
| Practice Address |
3 Maple St Kent CT 06757-1711 |
| Mailing Address |
3 Maple St Po Box 632 Kent CT 06757-1711 |
| Practice Telephone | 8666060440 |
| Mailing Telephone | 8666060440 |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2011-02-21 |
| Authorized Official Name | MR. PETER B DAPRILE (MEMBER) |
| Authorized Official Telephone | 8666060440 |
| Authorized Official Credential | RPH, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PCY1921 | CT | Suppliers |
| Street Address |
3 MAPLE ST |
| City | KENT |
| State | CT |
| Zip Code | 06757-1711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942251046 | Kent Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 3 Maple St, Kent, CT 06757 | 2006-05-13 |
| 1982648770 | Robert H. Stack | Pharmacist | 3 Maple St, Kent, CT 06757-1711 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831544030 | Samantha K Case | Social Worker | 62 Carter Road, Kent, CT 06757 | 2016-04-26 |
| 1639545015 | Stephanie Mauri | Dental Hygienist | 8 Green Pastures Ln, Kent, CT 06757 | 2015-08-19 |
| 1275946881 | High Watch Recovery Center | Substance Abuse Rehabilitation Facility | 62 Carter Rd., Kent, CT 06757 | 2014-06-11 |
| 1538592225 | Mary E. Smith Bowen | Licensed Practical Nurse | 46 Maple St, The Kent, Kent, CT 06757 | 2013-08-16 |
| 1629390620 | Kent Volunteer Fire Department, Inc. | Ambulance | 28 Maple St., Kent, CT 06757 | 2010-02-18 |
| 1407021959 | Gayle Pantaleo | Social Worker | 17 Old Barn Road, Kent, CT 06757 | 2008-04-25 |
| 1891992160 | Margaret Farley Mcmorrow | Acupuncturist | Progressive Medicine, 17 Old Barn Road, Kent, CT 06757 | 2007-06-29 |
| 1407981681 | Dan Traub | Specialist/Technologist | Kent School 1 Macedonia Rd., Kent, CT 06757 | 2007-02-21 |
| 1518057942 | Michael G Monsarrat | Dentist | 37 N Main St, Kent, CT 06757 | 2006-10-14 |
| 1891800512 | Leonard Jerome Astrauskas | Internal Medicine | 27 North Main Street, Unit 7a, Kent, CT 06757 | 2006-08-20 |
| Find all providers in zip 06757 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568987774 | Enfield Compounding Center LLC | Pharmacy | 139 Hazard Ave Unit 15, Enfield, CT 06082-4585 | 2017-08-08 |
| 1245685536 | Grandhi LLC | Pharmacy | 15 Corporate Dr Ste 1-1, Trumbull, CT 06611-1351 | 2016-04-25 |
| 1477574424 | Pharmagen Laboratories | Pharmacy | 30 Buxton Farms Road, Suite 110, Stamford, CT 06905 | 2006-07-22 |
| 1649251372 | Bunker Hill Pharmacy Inc | Pharmacy | 256 Bunker Hill Ave, Waterbury, CT 06708-2253 | 2005-11-09 |
| 1689676074 | Jewett City Pharmacy | Pharmacy | 78 Main St, Jewett City, CT 06351-2226 | 2005-08-15 |
| 1073130787 | Wassef LLC | Pharmacy | 535 Boston Post Rd, Old Saybrook, CT 06475-1506 | 2020-06-29 |
| 1225482490 | Medical Center Pharmacy Inc | Pharmacy | 1100 Sherman Ave, Hamden, CT 06514 | 2016-04-14 |
| 1588902563 | Ct Healthcare Services LLC | Pharmacy | 46 Broad St, New Britain, CT 06053-4305 | 2013-01-24 |
| 1316062904 | Pioneer Health Compounding Pharmcacy | Pharmacy | 520 Hartford Tpke, Suite D, Vernon, CT 06066-5037 | 2007-03-20 |
| 1740374156 | Turrill Drug Inc | Pharmacy | 31 Old Route 7, Brookfield, CT 06804-1711 | 2006-10-03 |
| Find all providers with the same taxonomy | ||||
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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.