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Organization
CUSTOM DOSING NORTH PC
Active
Organization
CUSTOM DOSING NORTH PC
Active
Other names
Custom Dosing Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BARTON RPH (OWNER)
(219) 465-2181
Entity
Organization
Contact information
Practice address
2701 BEECH ST, UNIT R, VALPARAISO, IN 46383-6010
(219) 465-2181
(219) 464-4382
Mailing address
2701 BEECH ST, UNIT R, VALPARAISO, IN 46383-6010
(219) 465-2181
(219) 464-4382
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
60006264A
IN
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
054019539
IL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130963
PK
—
Enumeration date
07/20/2011
Last updated
03/17/2017
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