Customedica Pharmacy Inc
Compounding Pharmacy
149 W State St Ste 101, Eagle
Idaho, 83616-4911
208-939-8008 208-938-1067
Customedica Pharmacy Inc is a Compounding Pharmacy in Eagle, Idaho. 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 Pharmacy Inc 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 Pharmacy Inc is 1651RP for Compounding Pharmacy in Idaho.
Customedica Pharmacy Inc 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 Pharmacy 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: | Customedica Pharmacy Inc |
| 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 Pharmacy Inc 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 Pharmacy Inc at
149 W State St Ste 101, Eagle, Idaho or can
call on customer care at 208-939-8008.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.