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Customedica Pharmacy, Inc
Compounding Pharmacy in Eagle, Idaho
NPI 1780729988

Customedica Pharmacy, Inc is a Compounding Pharmacy based in Eagle, ID and is specialized in Compounding Pharmacy. Customedica Pharmacy, Inc practices in Eagle, ID. The NPI Number for Customedica Pharmacy, Inc is 1780729988 and holds a License No. 1651CP (Idaho).

The current practice location address for Customedica Pharmacy, Inc is 149 W State St, Eagle, ID and can be reached out via phone at 208-939-8008 and via fax at 208-938-1067.

Location: 149 W State St, Eagle, ID, 83616-4959
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1780729988
Provider Name
Customedica Pharmacy, Inc
Credential
Provider Entity Type
Organization
Address
149 W State St, Eagle, ID, 83616-4959
Phone Number
208-939-8008
Fax Number
208-938-1067
Provider Enumeration Date
02/21/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1651CP 01 ID STATE LICENSE #
806251800 05 ID
institution
Provider Business Practice Location Address Details
Address
149 W State St
City
Eagle
State
Idaho
Zip
83616-4959
Phone Number
208-939-8008
Fax Number
208-938-1067
person
Provider Business Mailing Address Details
Address
149 W State St
City
Eagle
State
Idaho
Zip
83616-4959
Phone Number
208-939-8008
Fax Number
208-938-1067
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
3336C0003X
License No.
1651CP (Idaho)
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Compounding Pharmacy
Taxonomy
3336C0004X
License No.
1651CP (Idaho)
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
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