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CUSTOM HEALTH PHARMACY INC

Medical Equipment Supplier Yellow Pages

Green Bay, Wisconsin

Provider NPI: 1104088020

Organization Information:
Organization Name:  CUSTOM HEALTH PHARMACY INC


Practice Location:
844 WILLARD DR STE 7  GREEN BAY, WI 54304 US
Tel: 920-884-7345  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N333600000XSuppliers
Pharmacy
Y3336C0004XSuppliers
Pharmacy
WI9354-42

Other Provider Identifiers:

IssuerNumberStateType
PK213353601
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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