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Organization

CUSTOM COMPOUNDING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PETER B DAPRILE RPH, MBA (MEMBER)
(866) 606-0440
Entity
Organization

Contact information

Practice address
3 MAPLE ST, KENT, CT 06757-1711
(866) 606-0440
Mailing address
3 MAPLE ST, PO BOX 632, KENT, CT 06757-1711
(866) 606-0440

Taxonomy

Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PCY1921
CT

Other

Enumeration date
02/21/2011
Last updated
02/21/2011
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