CUSTOM CARE PHARMACY, LLC (NPI# 1730510074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730510074 |
| Entity Type | Organization |
| Organization Name | CUSTOM CARE PHARMACY, LLC |
| Other Organization Name | CUSTOM CARE PHARMACY |
| Practice Address |
132 E Northside Dr Suite C Clinton MS 39056-3415 |
| Practice Telephone | 6014884360 |
| Practice Fax Number | 8777475326 |
| Mailing Telephone | 6014884360 |
| Mailing Fax Number | 8777475326 |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |
| Authorized Official Name | MARCO MORAN (PHARMICIST-IN-CHARGE) |
| Authorized Official Telephone | 3187913765 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
07892/2.2 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2143363 | 01 |
| Other Name | Type Code |
|---|---|
| Custom Care Pharmacy | Doing Business As Name - Organization |
| Street Address |
132 E NORTHSIDE DR SUITE C |
| City | CLINTON |
| State | MS |
| Zip Code | 39056-3415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1225534530 | Magnolia Allergy Clinic LLC | Internal Medicine | 402 Cynthia St Ste E, Clinton, MS 39056 | 2018-04-04 |
| 1578093704 | Melinda A Weisenberger | Specialist/Technologist | 4600 W Northside Drive, Clinton, MS 39056 | 2017-06-20 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1023412822 | Rebecca Brooks Prewitt | Social Worker | 130 B Fairmont Street, Clinton, MS 39056 | 2014-10-22 |
| 1396184149 | Robert Joseph Hargis | Urology | 116 Afton Way, Clinton, MS 39056 | 2013-06-14 |
| 1750626321 | Clinton Dental Care, Inc. | Dentist | 736 Clinton Pkwy, Clinton, MS 39056 | 2012-12-07 |
| 1922394469 | Daphenia C. Knight Starling | Nurse Practitioner | Clinton Healthcare, 1251 Pinehaven Rd, Clinton, MS 39056 | 2011-06-23 |
| 1134443385 | Gwendolyn Coleman Garror | Pharmacist | 132 Fairmount Drive, Clinton, MS 39056 | 2010-03-17 |
| Find all providers in zip 39056 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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 process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700342896 | Mendel Pharmacy Inc | Pharmacy | 9131 Piscataway Rd Ste 200, Clinton, MD 20735-2578 | 2019-02-14 |
| 1568902427 | Clinton Pharmacy LLC | Pharmacy | 119 E Clay St, Clinton, KY 42031-1222 | 2017-02-26 |
| 1063965101 | Jcm Enterprises Inc | Pharmacy | 910 N Charles G Seivers Blvd, Clinton, TN 37716-3816 | 2016-07-25 |
| 1154702900 | Hunts Mill Pharmacy Inc | Pharmacy | 14 Main St Fl 1, Clinton, NJ 08809 | 2015-06-17 |
| 1053702860 | Wal-mart Stores East Lp | Pharmacy | 9181 Highway 67, Clinton, LA 70722-4919 | 2015-02-16 |
| 1134543440 | Physicans Rx Pharmacy of Clinton Inc | Pharmacy | 9131 Piscataway Rd Ste 670, Clinton, MD 20735-2579 | 2014-02-06 |
| 1609216498 | Dirigo Drug LLC | Pharmacy | 1144 Main Street, Clinton, ME 04927 | 2013-06-26 |
| 1487942298 | Wagner Pharmacy Company | Pharmacy | 1726 N. 2nd Street, Clinton, IA 52732 | 2011-07-13 |
| 1184883019 | Walgreen Co | Pharmacy | 9001 Woody Ter Ste B, Clinton, MD 20735-4256 | 2008-06-05 |
| 1437362209 | Clinton Drugstore | Pharmacy | 1027 St Helena, Clinton, LA 70722-1027 | 2007-05-08 |
| Find all providers in CLINTON | ||||
Please comment or provide details below to improve the information on CUSTOM CARE PHARMACY, LLC.
| 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.