# REYNOLDS PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Doctors Custom Compounding
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922013564
- **Authorized official:** DAN REYNOLDS (PRESIDENT OWNER)
- **Authorized official phone:** (262) 473-3444

## Contact information

- **Practice address:** 162 W MAIN ST STE K, WHITEWATER, WI 53190-1995
- **Practice address phone:** (262) 473-3444
- **Practice address fax:** (262) 473-3444
- **Mailing address:** 162 W MAIN ST, STE K, WHITEWATER, WI 53190-1995
- **Mailing address phone:** (262) 473-3444
- **Mailing address fax:** (262) 473-3444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9277-42 | WI | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 10/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2114604 | PK | — |
| 05 | — | 33061500 | — | WI |