Organization
CUSTOM CARE PHARMACY LLC
Active
Other names
Custom Care Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VISHALI PATEL RPH (PIC/ OWNER)
(661) 319-1150
Entity
Organization
Contact information
Practice address
7007 NORTH AVE, OAK PARK, IL 60302-1001
(708) 628-5464
Mailing address
7007 NORTH AVE, OAK PARK, IL 60302-1001
(708) 628-5464
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054.018588
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146437
PK
—
Enumeration date
06/12/2014
Last updated
03/16/2015
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