Organization
CUSTOM RX COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERNE BETLACH R.PH., FIACP (PHARMACIST)
(612) 866-2211
Entity
Organization
Contact information
Practice address
6519 NICOLLET AVE, SUITE 201, RICHFIELD, MN 55423-1669
(612) 866-2211
(612) 866-9217
Mailing address
6519 NICOLLET AVE, SUITE 201, RICHFIELD, MN 55423-1669
(612) 866-2211
(612) 866-9217
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
261509-5
MN
Other
Enumeration date
09/15/2006
Last updated
08/22/2020
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