| NPI | 1912154774 |
|---|---|
| Doing Business As | MD CUSTOM RX |
| Entity Type | Organization |
| Authorized Contact | MONICA ZATARSKI President 262-373-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054017646) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: MI 5301010339) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 8844-42) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MN 263654) | |
| Enumeration Date | 2008-08-24 |
| Last Update Date | 2018-07-19 |