CUSTOM PRESCRIPTION COMPOUNDERS LLC (NPI# 1093023020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093023020 |
| Entity Type | Organization |
| Organization Name | CUSTOM PRESCRIPTION COMPOUNDERS LLC |
| Other Organization Name | CUSTOM PRESCRIPTION COMPOUNDERS LLC |
| Practice Address |
194 Crepe Myrtle Ct Aiken SC 29803-7543 |
| Mailing Address |
Po Box 5490 Aiken SC 29804-5490 |
| Practice Telephone | 8036491175 |
| Practice Fax Number | 8036491175 |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2013-07-16 |
| Authorized Official Name | RICHARD HEATON (OWNER) |
| Authorized Official Telephone | 8036491175 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
10741 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2126865 | 01 |
| Other Name | Type Code |
|---|---|
| Custom Prescription Compounders LLC | Doing Business As Name - Organization |
| Street Address |
194 CREPE MYRTLE CT |
| City | AIKEN |
| State | SC |
| Zip Code | 29803-7543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871147454 | Augusta Oncology Associates, P.C. | Specialist | 222 University Parkway, Aiken, SC 29803 | 2019-07-31 |
| 1356804546 | Ebony Johnson | Home Health Aide | 942 C Dougherty Rd, Aiken, SC 29803 | 2019-04-13 |
| 1689144230 | Tabatha Lee Maddox | Occupational Therapist | 550 East Gate Dr, Aiken, SC 29803 | 2018-11-27 |
| 1962995100 | Pvd Internal Medicine Associates LLC | Internal Medicine | 440 Society Hill Dr Ste B, Aiken, SC 29803 | 2018-06-12 |
| 1689197691 | Trent David Yoder | Dentist | 174 Crepe Myrtle Drive, Aiken, SC 29803 | 2017-07-21 |
| 1770039331 | Lauren Reigot | Physical Therapist | 6140 Woodside Executive Ct., Aiken, SC 29803 | 2016-09-01 |
| 1851747190 | Umg Primary Care South Carolina, LLC | Family Medicine | 1023 Silver Bluff Road, Aiken, SC 29803 | 2016-05-05 |
| 1912375759 | Lisa G Browning | Nurse Practitioner | 550 E. Gate Drive, Aiken, SC 29803 | 2015-09-10 |
| 1346682754 | Tyresia Jovon White | Dentist | 440 Society Hill Dr Ste 201, Aiken, SC 29803 | 2013-07-25 |
| 1528327483 | Caresouth Hospice, LLC | Hospice Care, Community Based | 37 Varden Drive, Suite B, Aiken, SC 29803 | 2012-05-14 |
| Find all providers in zip 29803 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| 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. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720076540 | Mjw Corporation | Pharmacy | 110 Price Avenue, Aiken, SC 29803-7395 | 2005-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689276 | Sweetgrass Pharmacy Carolina Park, LLC | Pharmacy | 3485 Park Avenue Blvd, Mount Pleasant, SC 29466 | 2020-11-02 |
| 1740890433 | Polaris Jack, Inc. | Pharmacy | 3072 Dick Pond Rd Unit 2, Myrtle Beach, SC 29588-6954 | 2020-08-06 |
| 1780147504 | Cherry Grove Compounding, LLC | Pharmacy | 1124-2 Sea Mountain Highway, North Myrtle Beach, SC 29582 | 2019-04-09 |
| 1982071296 | Benzer Sc 1 LLC | Pharmacy | 1028 Edgewater Pkwy, Suite 103, Indian Land, SC 29707 | 2015-08-24 |
| 1669889374 | Sweetgrass Pharmacy & Compounding LLC | Pharmacy | 1952 Long Grove Dr Ste 5, Mt Pleasant, SC 29464-7579 | 2014-07-14 |
| 1518395656 | Compounding Solutions Pharmacy LLC | Pharmacy | 115 Pelham Rd Ste 12, Greenville, SC 29615-2155 | 2013-10-29 |
| 1447699871 | Greenhill Pharmacy Inc | Pharmacy | 2531 Woodruff Rd Ste 107, Simpsonville, SC 29681-5465 | 2013-06-19 |
| 1821337221 | Pawleys Island Compounding Pharmacy LLC | Pharmacy | 9710 Ocean Hwy, Unit 2, Pawleys Island, SC 29585-7585 | 2013-02-05 |
| 1033423348 | Specialty Pharmacy Myrtle Beach LLC | Pharmacy | 5900 N Kings Hwy Ste C, Myrtle Beach, SC 29577-2326 | 2010-07-28 |
| 1942527452 | Infuscience South Carolina LLC | Pharmacy | 462 Wando Park Blvd, Suite A, Mt Pleasant, SC 29464-7906 | 2010-04-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.