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Organization
CUSTOM CARE PHARMACY LLC
Active
Organization
CUSTOM CARE PHARMACY LLC
Active
Other names
Custom Care Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VISHALI PATEL RPH (PIC/ OWNER)
(661) 319-1150
Entity
Organization
Contact information
Practice address
7007 NORTH AVE, OAK PARK, IL 60302-1001
(708) 628-5464
Mailing address
7007 NORTH AVE, OAK PARK, IL 60302-1001
(708) 628-5464
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054.018588
IL
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146437
PK
—
Enumeration date
06/12/2014
Last updated
03/16/2015
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