Organization
TIBERIUS
Active
Other names
CUSTOM SRIPTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CASTILLO (OWNER)
(813) 871-6154
Entity
Organization
Contact information
Practice address
27732 CASHFORD CIR, WESLEY CHAPEL, FL 33544-6964
(813) 871-6154
(813) 876-9095
Mailing address
27732 CASHFORD CIR, WESLEY CHAPEL, FL 33544-6964
(813) 871-6154
(813) 876-9095
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH13938
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022348
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/20/2006
Last updated
04/13/2012
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