Organization
CUSTOM RX LLC
Active
Other names
Custom Rx Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROY DAVID KATZ R.PH. (OWNER)
(612) 866-2211
Entity
Organization
Contact information
Practice address
6519 NICOLLET AVE, STE 201, RICHFIELD, MN 55423-1669
(612) 866-2211
(612) 866-9217
Mailing address
6519 NICOLLET AVE, STE 201, RICHFIELD, MN 55423-1669
(612) 866-2211
(612) 866-9217
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
263528
MN
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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