Organization
RCR EAST, LLC
Active
Other names
Custom Rx Pharmacy & Wellness Concepts
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLAS L BRANAM PHARM.D. (PIC)
(316) 636-9595
Entity
Organization
Contact information
Practice address
2350 N GREENWICH RD, SUITE 1000, WICHITA, KS 67226-8269
(316) 636-9595
(316) 636-9591
Mailing address
2350 N GREENWICH RD, SUITE 1000, WICHITA, KS 67226-8269
(316) 636-9595
(316) 636-9591
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
210265
KS
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004631360001
—
KS
Enumeration date
12/27/2006
Last updated
02/25/2022
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