Customedica Compounding Center is not a DME supplier for medicare equipments and products.
Customedica Compounding Center is a Compounding Pharmacy in Eagle, Idaho. This pharmacy is owned and operated by Customedica Pharmacy Inc. It is located at 149 W State St Ste 101, Eagle and it's customer support contact number is 208-939-8008. The authorized person of Customedica Compounding Center is Shah Afshar, PHARM.D. who is Cheif Pharmacist of the pharmacy and his contact number is 208-939-8008. Active license number of Customedica Compounding Center is 1651RP for Compounding Pharmacy in Idaho. Customedica Compounding Center is 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.
Pharmacy Details:
Customedica Compounding Center 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:
Customedica Compounding Center
Type:
Compounding Pharmacy
Location:
149 W State St Ste 101, Eagle, Idaho, 83616-4911
Phone:
208-939-8008
Fax:
208-938-1067
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:
Shah Afshar
Credentials:
PHARM.D.
Position:
Cheif Pharmacist
Contact Number:
208-939-8008
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:
1508162454
NPI Enumeration Date:
09 Feb, 2011
NPI Last Update On:
17 Aug, 2016
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Customedica Compounding Center are as mentioned below.
Specialization
License Number
State
Status
Compounding Pharmacy
1651RP
Idaho
Primary
Pharmacy
Secondary
Community/Retail Pharmacy
Secondary
Specialty 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
2128455
Other
Pk
806251800
Medicaid
Idaho
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
149 W State St, Suite 101 Eagle, Idaho
Zip:
83616-4901
Phone Number:
208-939-8008
Fax Number:
208-938-1067
Patients can reach Customedica Compounding Center at 149 W State St Ste 101, Eagle, Idaho or can call on customer care at 208-939-8008.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.
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