Custom Health Pharmacy Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

9354-42 Issued in WI

Legal business name

CUSTOM HEALTH PHARMACY INC

Practice address

844 Willard Dr Ste 7
Green Bay, WI 54304-5265

Phone

(920) 884-7345

Fax

(920) 884-7346

NPI assigned

Jul 1, 2008

Organization subpart

No

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

Authorized official

Name

John Sowinski

Title

Pharmacist/President

Phone

(920) 482-3145

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Custom Health Pharmacy, Inc Doing business as

Locations

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1104088020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 WILLARD DR STE 7",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045265",
            "telephone_number": "920-884-7345",
            "fax_number": "920-884-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 WILLARD DR STE 7",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045265",
            "telephone_number": "920-884-7345",
            "fax_number": "920-884-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM HEALTH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "SOWINSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACIST/PRESIDENT",
        "authorized_official_telephone_number": "920-482-3145"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "WI",
            "license": "9354-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133536",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Health Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Shua Cunningham, BCBA
• Curative Connections, Inc.
• Melissa Curiel Nunez
• Kelly M Curran, OTR
• Tanya Curran
• Customized Health Care Services, LLC
• Robert Thomas Cutlan, MD
• Monica A Czachor, PT
• Christine Czechanski
• Anne Marie Czyz-Klemens, DMD

• Compounding Pharmacy in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Compounding Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; 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.