KUSTOM WELLNESS, INC (NPI# 1710403043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710403043 |
| Entity Type | Organization |
| Organization Name | KUSTOM WELLNESS, INC |
| Other Organization Name | KUSTOM WELLNESS |
| Practice Address |
4550 Donald Ross Rd Ste 113 Palm Beach Gardens FL 33418-5104 |
| Practice Telephone | (561) 469-1558 |
| Mailing Telephone | 5614691558 |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | DR. TRACY KIRKPATRICK (PRESIDENT) |
| Authorized Official Telephone | 5614691558 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Kustom Wellness | Doing Business As Name - Organization |
| Street Address |
4550 DONALD ROSS RD STE 113 |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33418-5104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031447 | Jorge Wilfrido Avila | Psychiatry & Neurology | 118 Emerald Key Ln., Palm Beach Gardens, FL 33418 | 2020-10-20 |
| 1518438852 | Jessica E Harrison, Lcsw | Clinic/Center | 900 East Indiantown Road, 310, Palm Beach Gardens, FL 33418 | 2018-12-16 |
| 1275000879 | Dentists of Palm Beach Gardens, Pa | Dentist | 5380 Donald Ross, Rd., Suite 100, Palm Beach Gardens, FL 33418 | 2018-11-01 |
| 1861979932 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5410 Donald Ross Rd, Palm Beach Gardens, FL 33418 | 2018-07-23 |
| 1194240150 | Private Home Care LLC | Home Health | 5211 Celery Ln, Palm Beach Gardens, FL 33418 | 2017-08-10 |
| 1053836791 | Ashley Mooney | Pharmacist | 6251 Ave of The Pga, Palm Beach Gardens, FL 33418 | 2017-08-03 |
| 1063950343 | Spinal Motion Diagnostics Fort Lauderdale LLC | Clinic/Center | 8435 Man O War Road, Palm Beach Gardens, FL 33418 | 2017-02-07 |
| 1588108823 | Fernando Javier Rodriguez | Pharmacist | 290 Woodbine Way, Apt 215, Riviera Beach, FL 33418 | 2016-12-06 |
| 1811430036 | Lauren Alexandra Kratofil | Physical Therapist | 300 Avenue of The Champions, Palm Beach Gardens, FL 33418 | 2016-11-19 |
| 1417403221 | Ahava-5772, LLC | Chiropractor | 5540 Pga Boulevard, Suite 100, Palm Beach Gardens, FL 33418 | 2016-08-31 |
| Find all providers in zip 33418 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205377173 | Premier Compounding Pharmacy, Inc. | Pharmacy | 2000 Pga Blvd., Suite 5507, Palm Beach Gardens, FL 33408 | 2017-03-13 |
| 1053762260 | Northlake Pharmacy LLC | Pharmacy | 9091 N Military Trl Ste 17, Palm Beach Gardens, FL 33410-5983 | 2016-06-29 |
| 1821301706 | Publix Super Markets Inc | Pharmacy | 4101 Hood Rd, Palm Beach Gardens, FL 33410-2171 | 2010-07-20 |
| 1700825759 | Publix Super Markets Inc | Pharmacy | 9900 Alternate A1a, Palm Beach Gardens, FL 33410-4903 | 2006-06-05 |
| 1700823234 | Albertsons LLC | Pharmacy | 4407 Northlake Blvd, Palm Beach Gardens, FL 33410-6255 | 2006-06-01 |
| 1467439927 | Gardens Drugs Inc | Pharmacy | 10800 N Military Trl, Suite 119, Palm Beach Gardens, FL 33410-6500 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452974 | Curry Ford Pharmacy LLC | Pharmacy | 4538 Curry Ford Rd, Orlando, FL 32812-2711 | 2020-09-19 |
| 1225641525 | Englewood Pharmaceutical Services Inc | Pharmacy | 1720 S Mccall Rd Ste J, Englewood, FL 34223-4867 | 2020-08-26 |
| 1972115103 | Intellrx Consulting LLC | Pharmacy | 1257 The 12th Fairway, Wellington, FL 33414-5738 | 2020-08-19 |
| 1518577576 | Publix Super Markets, Inc | Pharmacy | 7340 Kathleen Rd, Lakeland, FL 33810-4495 | 2020-08-05 |
| 1962011890 | Green Star Pharmacy | Pharmacy | 2950 Winkler Ave Ste 701, Fort Myers, FL 33916-9322 | 2020-07-27 |
| 1356959134 | Cverx Pharmacy Corp | Pharmacy | 7360 Sw 24th St Ste 29, Miami, FL 33155-1462 | 2020-07-17 |
| 1447877287 | Jerry Voltaire | Pharmacy | 16470 Cedar Run Dr, Orlando, FL 32828-6970 | 2020-06-27 |
| 1598381980 | John Melvin Schemm IIi | Pharmacy | 7617 Bay Port Rd, Orlando, FL 32819-5504 | 2020-06-22 |
| 1891318267 | Empire Specialty Pharmacy LLC | Pharmacy | 749 S Apollo Blvd, Melbourne, FL 32901-1457 | 2020-05-20 |
| 1992334205 | Mypills Pharmacy LLC | Pharmacy | 303a E 1st St, Sanford, FL 32771-1377 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33418 |
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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.