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Organization
COLUMBUS CUSTOM RX, LLC
Active
Organization
COLUMBUS CUSTOM RX, LLC
Active
Other names
Columbus Custom Rx Pharmacy: Compounding and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
CHARITY CALHOUN WAGENTI (OWNER)
(706) 405-3277
Entity
Organization
Contact information
Practice address
3290 WILLIAMS RD STE BANDC, COLUMBUS, GA 31909-5614
(706) 593-3927
Mailing address
3290 WILLIAMS RD STE BANDC, COLUMBUS, GA 31909-5614
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
05/05/2023
Last updated
03/12/2024
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