| NPI | 1912739590 |
|---|---|
| Doing Business As | CUSTOM RX SHOPPE |
| Entity Type | Organization |
| Authorized Contact | KEVIN FARIS CEO 360-685-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-14 |