Organization
CUSTOM PRESCRIPTIONS OF LANCASTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE M BOOMSMA PHARM D (PRESIDENT)
(717) 393-0518
Entity
Organization
Contact information
Practice address
902 N DUKE ST, LANCASTER, PA 17602
(717) 393-0518
(717) 393-0519
Mailing address
902 N DUKE ST, LANCASTER, PA 17602-1906
(717) 393-0518
(717) 393-0519
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
PP481682
PA
3336C0004X
Compounding Pharmacy
Primary
PP481682
PA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
PP481682
PA
Other
Enumeration date
06/08/2007
Last updated
02/02/2021
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