Organization
CUSTOM MEDICATION AND COMPLIANCE SPECIALISTS INC
Active
Other names
CMC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EBELL HSIEH PHARM D (PHARMACIST-IN-CHARAGE)
(706) 884-2843
Entity
Organization
Contact information
Practice address
18 NEW AIRPORT RD, STE C, LAGRANGE, GA 30240-1410
(706) 884-2843
(706) 884-8123
Mailing address
18 NEW AIRPORT RD, STE C, LAGRANGE, GA 30240-1410
(706) 884-2843
(706) 884-8123
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
PHRE010299
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098311415A
—
GA
01
—
2016320
PK
—
Enumeration date
08/03/2006
Last updated
06/19/2019
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