# CUSTOM CARE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Custom Care Pharmacy LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699189134
- **Authorized official:** VISHALI PATEL RPH (PIC/ OWNER)
- **Authorized official phone:** (661) 319-1150

## Contact information

- **Practice address:** 7007 NORTH AVE, OAK PARK, IL 60302-1001
- **Practice address phone:** (708) 628-5464
- **Mailing address:** 7007 NORTH AVE, OAK PARK, IL 60302-1001
- **Mailing address phone:** (708) 628-5464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054.018588 | IL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/12/2014
- **Last updated:** 03/16/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2146437 | PK | — |