Organization
CUSTOM DOSING NORTH PC
Active
Other names
Custom Dosing Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BARTON RPH (OWNER)
(219) 465-2181
Entity
Organization
Contact information
Practice address
2701 BEECH ST, UNIT R, VALPARAISO, IN 46383-6010
(219) 465-2181
(219) 464-4382
Mailing address
2701 BEECH ST, UNIT R, VALPARAISO, IN 46383-6010
(219) 465-2181
(219) 464-4382
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
60006264A
IN
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
054019539
IL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130963
PK
—
Enumeration date
07/20/2011
Last updated
03/17/2017
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