Organization
CPPLTC LLC
Active
Other names
Custom Plus Long Term Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW HUTERA (OWNER)
(654) 214-3762
Entity
Organization
Contact information
Practice address
482 W NAVAJO ST STE B, WEST LAFAYETTE, IN 47906-1940
(765) 607-4103
(765) 607-4109
Mailing address
482 W NAVAJO ST STE B, WEST LAFAYETTE, IN 47906-1940
(765) 607-4103
(765) 607-4109
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
05/28/2015
Last updated
10/20/2020
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