CUSTOM RX INC (NPI# 1811091879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811091879 |
| Entity Type | Organization |
| Organization Name | CUSTOM RX INC |
| Other Organization Name | CUSTOM RX PHARMACY & WELLNESS CONCEPTS |
| Practice Address |
3510 N Ridge Rd Ste 900 Wichita KS 67205-1225 |
| Practice Telephone | 3167212626 |
| Practice Fax Number | 3167214823 |
| Mailing Telephone | 3167212626 |
| Mailing Fax Number | 3167214823 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | JAN GERBER (PRESIDENT) |
| Authorized Official Telephone | 3167212626 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH00004390 | NM | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
44645MS | ID | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
4477 | IA | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
054.019573 | IL | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
64001361A | IN | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
209867 | KS | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH17904 | FL | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
2012019217 | MO | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH02874 | NV | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
264830 | MN | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHNR000914 | GA | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHAR1497 | ND | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
758 | NE | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
13708 | NC | Suppliers |
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
OS02495 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100445230C | 05 | |
| PK | 2027079 | 01 |
| Other Name | Type Code |
|---|---|
| CUSTOM RX PHARMACY & WELLNESS CONCEPTS | Doing Business As Name - Organization |
| Street Address |
3510 N RIDGE RD STE 900 |
| City | WICHITA |
| State | KS |
| Zip Code | 67205-1225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211910 | Emily M Chastain | Dentist | 3213 N. Ridge Rd, Wichita, KS 67205 | 2018-07-16 |
| 1811415466 | Awaken Psychology LLC | Clinic/Center | 2552 N Maize Ct Suite 600, Wichita, KS 67205 | 2017-09-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1649637653 | Abigail Friend | Audiologist-Hearing Aid Fitter | 2558 Lake Way Circle, Wichita, KS 67205 | 2016-01-21 |
| 1134505399 | Myles Davidson | Dentist | 3510 N Ridge Rd Ste 500, Wichita, KS 67205 | 2015-08-10 |
| 1093121097 | The Eye Gallery, LLC | Optometrist | 3084 N. Maize Rd, Wichita, KS 67205 | 2014-07-10 |
| 1922428721 | Sam's West, Inc. | Technician/Technologist | 3084 N. Maize Road, Witchita, KS 67205 | 2014-04-18 |
| 1447693627 | Caryn Rana Landreth | Social Worker | 3114 N Brush Creek St, Wichita, KS 67205 | 2013-04-08 |
| 1902182686 | Return To Motion Medical | Durable Medical Equipment & Medical Supplies | 3221 N Ridge Port Circle, Wichita, KS 67205 | 2011-10-26 |
| Find all providers in zip 67205 | ||||
| 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 |
|---|---|---|---|---|
| 1083611867 | Hart Pharmacy Inc | Pharmacy | 6217 E 13th St N, Wichita, KS 67208-2654 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083276240 | Pain Management Partner Inc. | Pharmacy | 13330 Santa Fe Trail Dr, Lenexa, KS 66215-3653 | 2019-07-08 |
| 1982081501 | Kare Pharmacy of Lansing LLC | Pharmacy | 426 Delaware St, Leavenworth, KS 66048-2733 | 2015-05-04 |
| 1184057168 | Haag Apothecary, Inc | Pharmacy | 1400 W 12th Ave Ste A, Emporia, KS 66801-2516 | 2013-08-14 |
| 1093031502 | Bb37 Pa | Pharmacy | 505 E 16th St, Suite 2, Wellington, KS 67152-2811 | 2010-04-09 |
| 1073764973 | Gripka Pharmacy LLC | Pharmacy | 15415 Pinehurst Dr, Basehor, KS 66007-8237 | 2008-10-09 |
| 1316107162 | Senior Rx Care of Kansas LLC | Pharmacy | 121 Se 6th Ave, Topeka, KS 66603-3516 | 2008-06-16 |
| 1043421910 | Midwest Compounders, Inc | Pharmacy | 13330 Santa Fe Trail Drive, Lenexa, KS 66215 | 2007-05-24 |
| 1225189202 | Pharmscript of Ks LLC | Pharmacy | 11144 Renner Blvd, Lenexa, KS 66219 | 2007-01-16 |
| 1679640197 | Elmhurst Apothecary, LLC | Pharmacy | 1018 Elmhurst Blvd, Concordia, KS 66901-3900 | 2006-11-29 |
| 1972685063 | Hudson Holdings, Inc. | Pharmacy | 111 Oak St, Bonner Springs, KS 66012-1049 | 2006-10-19 |
| 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.