| NPI | 1053370932 |
|---|---|
| Doing Business As | CUSTOM PRESCRIPTION SHOPPE |
| Entity Type | Organization |
| Authorized Contact | ERIC HOLGATE President 706-737-3955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: GA PHRE007052) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2013-12-30 |