# CPPLTC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Custom Plus Long Term Care LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407235013
- **Authorized official:** MATTHEW HUTERA (OWNER)
- **Authorized official phone:** (654) 214-3762

## Contact information

- **Practice address:** 482 W NAVAJO ST STE B, WEST LAFAYETTE, IN 47906-1940
- **Practice address phone:** (765) 607-4103
- **Practice address fax:** (765) 607-4109
- **Mailing address:** 482 W NAVAJO ST STE B, WEST LAFAYETTE, IN 47906-1940
- **Mailing address phone:** (765) 607-4103
- **Mailing address fax:** (765) 607-4109

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/28/2015
- **Last updated:** 10/20/2020