# COLUMBUS CUSTOM RX, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Columbus Custom Rx Pharmacy: Compounding and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689363434
- **Authorized official:** CHARITY CALHOUN WAGENTI (OWNER)
- **Authorized official phone:** (706) 405-3277

## Contact information

- **Practice address:** 3290 WILLIAMS RD STE BANDC, COLUMBUS, GA 31909-5614
- **Practice address phone:** (706) 593-3927
- **Mailing address:** 3290 WILLIAMS RD STE BANDC, COLUMBUS, GA 31909-5614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/05/2023
- **Last updated:** 03/12/2024