Organization
CUSTOM MED, LLC
Active
Other names
Custom Med Plus
Organization subpart
No
Provider details
NPI number
Authorized official
INAS DAHABRA (MANAGER)
(708) 289-6721
Entity
Organization
Contact information
Practice address
4312 N. PULASKI, CHICAGO, IL 60641
(708) 289-6721
(779) 803-0170
Mailing address
4312 N. PULASKI, CHICAGO, IL 60641
(708) 289-6721
(779) 803-0170
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
07/13/2019
Last updated
02/08/2023
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