Organization
CUSTOM MED INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADERA ABU MAHFOUD (PHARMACIST IN CHARGE)
(317) 523-4310
Entity
Organization
Contact information
Practice address
23965 NOVI RD STE 100, NOVI, MI 48375-3232
(317) 340-1245
Mailing address
23965 NOVI RD STE 100, NOVI, MI 48375-3232
(317) 340-1245
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-
-
—
Enumeration date
01/05/2023
Last updated
01/05/2023
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