Organization
CUSTOMPRESCRIPTION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRIKANTH M SHIVAKUMAR M.PHARM, RPH (PRESIDENT)
(614) 397-6687
Entity
Organization
Contact information
Practice address
1620 E BROAD ST, SUITE 1005, COLUMBUS, OH 43203-2072
(614) 397-6687
Mailing address
1620 E BROAD ST, SUITE 1005, COLUMBUS, OH 43203-2072
(614) 397-6687
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03128002
OH
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
5302037600
MI
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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