Organization
CUSTOM IVY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG WARE (CEO/CFO/SEC.)
(949) 615-6534
Entity
Organization
Contact information
Practice address
72 ARGONAUT STE 130, ALISO VIEJO, CA 92656-4144
(949) 520-6864
Mailing address
72 ARGONAUT STE 130, ALISO VIEJO, CA 92656-4144
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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