Custom Pharmacy Innovations Inc
Community/Retail Pharmacy
10911 Ne 23rd, Nicoma Park
Oklahoma, 73066
405-769-8585 405-769-8787
Custom Pharmacy Innovations Inc is a Community/Retail Pharmacy in Nicoma Park, Oklahoma. It is located at 10911 Ne 23rd, Nicoma Park and it's customer support contact number is 405-769-8585. The authorized person of Custom Pharmacy Innovations Inc is Farhana Kabir who is Managing Owner of the pharmacy and his contact number is 405-769-8585. Active license number of Custom Pharmacy Innovations Inc is 18135 for Community/Retail Pharmacy in Oklahoma. Custom Pharmacy Innovations Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Custom Pharmacy Innovations Inc is 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.
Pharmacy Details:
Custom Pharmacy Innovations Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Custom Pharmacy Innovations Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 10911 Ne 23rd, Nicoma Park,
Oklahoma, 73066 |
| Phone: | 405-769-8585 |
| Fax: | 405-769-8787 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Farhana Kabir |
| Position: | Managing Owner |
| Contact Number: | 405-769-8585 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1073606240 |
| NPI Enumeration Date: | 02 Oct, 2006 |
| NPI Last Update On: | 28 Oct, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Custom Pharmacy Innovations Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 18135 | Oklahoma | Primary | |
| Compounding Pharmacy | | | Secondary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2077070 | Other | | Pk |
| 200095530A | Medicaid | Oklahoma | |
Medicare Enrollment:
Custom Pharmacy Innovations Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 9335146380 | O20061107000025 | Custom Pharmacy Innovations Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 489,
Nicoma Park, Oklahoma |
| Zip: | 73066-0489 |
| Phone Number: | 405-769-8585 |
| Fax Number: | 405-769-8787 |
Patients can reach Custom Pharmacy Innovations Inc at
10911 Ne 23rd, Nicoma Park, Oklahoma or can
call on customer care at 405-769-8585.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.