Custom Script LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009280 Issued in MI

Legal business name

CUSTOM SCRIPT LLC

Practice address

25302 W Warren St
Dearborn Heights, MI 48127-2102

Phone

(810) 588-0000

Fax

(888) 647-8587

NPI assigned

Jan 15, 2010

Last updated

Mar 23, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Eyad Khadr

Title

Owner

Phone

(810) 588-0000

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427068800000",
    "number": "1053642041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25302 W WARREN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272102",
            "telephone_number": "810-588-0000",
            "fax_number": "888-647-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25302 W WARREN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272102",
            "telephone_number": "810-588-0000",
            "fax_number": "888-647-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM SCRIPT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2015-03-23",
        "status": "A",
        "authorized_official_last_name": "KHADR",
        "authorized_official_first_name": "EYAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-588-0000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MI",
            "license": "5301009280",
            "primary": false
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert French Cranford
• Gwendolyn Crawford, LLMSW
• Danielle R Cronin, CNA
• Teresa Croughen, R.N.
• Ann Cser
• Olivia Czajkowski
• Franco D'Alfonso, RN
• Lara Dabajeh, DPT
• Ysen Dalipi
• Dally Diagnostics Inc

• Community/Retail Pharmacy in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.