CUSTOM RX COMPOUNDING PHARMACY (NPI# 1093811689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093811689 |
| Entity Type | Organization |
| Organization Name | CUSTOM RX COMPOUNDING PHARMACY |
| Practice Address |
6519 Nicollet Ave Suite 201 Richfield MN 55423-1669 |
| Practice Telephone | 6128662211 |
| Practice Fax Number | 6128669217 |
| Mailing Telephone | 6128662211 |
| Mailing Fax Number | 6128669217 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. VERNE BETLACH (PHARMACIST) |
| Authorized Official Telephone | 6128662211 |
| Authorized Official Credential | R.PH., FIACP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
261509-5 | MN | Suppliers |
| Street Address |
6519 NICOLLET AVE SUITE 201 |
| City | RICHFIELD |
| State | MN |
| Zip Code | 55423-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255763603 | Perez Chiropractic, LLC | Chiropractor | 6519 Nicollet Ave, Suite 300, Richfield, MN 55423-1669 | 2013-08-07 |
| 1922328657 | Custom Rx LLC | Pharmacy | 6519 Nicollet Ave, Ste 201, Richfield, MN 55423-1669 | 2010-06-04 |
| 1720280951 | Noelle Theresa Everts | Speech-Language Pathologist | 6519 Nicollet Ave, Suite 301, Richfield, MN 55423-1669 | 2007-06-01 |
| 1578781514 | Therapeutic Frameworks, Inc. | Occupational Therapist | 6519 Nicollet Ave, Suite 301, Richfield, MN 55423-1669 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841844081 | Ann Niebuhr | Counselor | 6417 Penn Ave S Ste 8 #2, Minneapolis, MN 55423 | 2019-07-25 |
| 1073021077 | Alton John Olson | Surgery | 7008 - Morgan Avenue South, Richfield, MN 55423 | 2018-01-12 |
| 1992238190 | Certified Care Planner LLC | Home Health | 1515 E 66th Street Suite 105, Richfield, MN 55423 | 2017-04-05 |
| 1245780121 | Rachel Lauren Marston | Audiologist | 7745 2nd Ave S., Suite 1, Richfield, MN 55423 | 2016-10-04 |
| 1023564093 | Justine Welch Mastin | Counselor | 6640 Lyndale Ave S Ste 110, Minneapolis, MN 55423 | 2016-08-30 |
| 1215480942 | Smart Choice Mri, LLC | Clinic/Center | 1704 E 66th St, Minneapolis, MN 55423 | 2016-07-29 |
| 1225425531 | Maria Lourdes Nolasco De Leon | Registered Nurse | 6511 12th Ave. S, Richfield, MN 55423 | 2015-04-24 |
| 1508261926 | Ally Medical Supply | Durable Medical Equipment & Medical Supplies | 6238 Lyndale Ave South, Suite # 2, Richfield, MN 55423 | 2014-10-28 |
| 1811230097 | Barb Rose Olson | Registered Nurse | 6461 Lyndale Ave. So, Richfield, MN 55423 | 2013-04-05 |
| 1902149404 | Nina Kae Hanevik | Registered Nurse | 6461 Lyndale Ave So, Richfield, MN 55423 | 2013-04-03 |
| Find all providers in zip 55423 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285785 | Richfield Community Pharmacy LLC | Pharmacy | 440 S Main St Ste B, Richfield, UT 84701-2855 | 2018-11-26 |
| 1508871815 | Walgreen Co | Pharmacy | 12 W 66th St, Richfield, MN 55423-2316 | 2006-07-29 |
| 1427242569 | Grand St Paul Cvs LLC | Pharmacy | 6445 Richfield Pkwy, Richfield, MN 55423-6400 | 2007-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368633 | Sawtooth Mountain Clinic, Inc. | Pharmacy | 513 5th Ave W Rm 201, Grand Marais, MN 55604-3017 | 2020-08-27 |
| 1891313326 | Rochester Community Pharmacy LLC | Pharmacy | 1604 1st St Nw, Rochester, MN 55901-0318 | 2020-07-10 |
| 1134745730 | Elko New Market Family Pharmacy, LLC | Pharmacy | 117 Old Town Road, Elko New Market, MN 55054 | 2020-06-19 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1205460169 | Genoa Healthcare, LLC | Pharmacy | 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 | 2020-02-28 |
| 1801438361 | The Duluth Clinic, Ltd. | Pharmacy | 2 Division St Ste A, Deer River, MN 56636-8779 | 2019-10-16 |
| 1265084792 | Nudak Ventures, LLC | Pharmacy | 5418 Saint Croix Trl, North Branch, MN 55056-4203 | 2019-07-15 |
| 1659938116 | Sterlingrx Inc | Pharmacy | 1312 Northland Dr Ste 500, Mendota Heights, MN 55120-1436 | 2019-05-21 |
| 1639734346 | Seward Pharmacy LLC | Pharmacy | 2209 E Lake St, Minneapolis, MN 55407-4563 | 2019-05-08 |
| 1093370694 | Minnesota Ave N Pharmacy Services Limited | Pharmacy | 226 Minnesota Ave N, Aitkin, MN 56431-1412 | 2019-05-08 |
| 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.