Organization
CUSTOM PRESCRIPTION SHOPPE LLC
Active
Organization
CUSTOM PRESCRIPTION SHOPPE LLC
Active
Other names
Custom Rx Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN FARIS RPH (CEO)
(360) 685-4282
Entity
Organization
Contact information
Practice address
5917 PORTAL WAY, FERNDALE, WA 98248-9361
(360) 685-4282
(360) 685-4283
Mailing address
5917 PORTAL WAY, FERNDALE, WA 98248-9361
(360) 685-4282
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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