Organization
CUSTOM SCRIPT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EYAD KHADR (OWNER)
(810) 588-0000
Entity
Organization
Contact information
Practice address
25302 W WARREN ST, DEARBORN HEIGHTS, MI 48127-2102
(810) 588-0000
(888) 647-8587
Mailing address
25302 W WARREN ST, DEARBORN HEIGHTS, MI 48127-2102
(810) 588-0000
(888) 647-8587
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
5301009280
MI
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009280
MI
Other
Enumeration date
01/15/2010
Last updated
03/23/2015
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