| NPI | 1720320088 |
|---|---|
| Doing Business As | CUSTOM SCRIPT INFUSION VITAL CARE |
| Entity Type | Organization |
| Authorized Contact | CHAD A WALLACE VP Operations 304-543-3292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV MP0552402) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: WV MP0552402) | |
| 333600000X Pharmacy (Licence: WV MP0552402) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: WV MP0552402) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2014-12-08 |