Organization
NORTH AMERICAN CUSTOM LABORATORIES LLC
Active
Other names
North American Custom Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN GRAVES (PRESIDENT/PIC)
(214) 240-6208
Entity
Organization
Contact information
Practice address
1736 N GREENVILLE AVE, RICHARDSON, TX 75081-1808
(214) 390-9990
(214) 432-8922
Mailing address
1736 N GREENVILLE AVE, RICHARDSON, TX 75081-1808
(214) 390-9990
(214) 432-8922
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147457
PK
—
Enumeration date
08/13/2014
Last updated
08/21/2014
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