Custom Script Pharmacy

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

CUSTOM SCRIPT PHARMACY

Practice address

3738 Teays Valley Rd Ste C
Hurricane, WV 25526-9705

Phone

(130) 473-3378

Fax

(130) 473-3139

NPI assigned

Sep 16, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jonathan Beaver, RRT

Title

Respiratory Therapist

Phone

(304) 733-3784

Specialties & licenses 1

Addresses

Tax ID family

Custom Script Infusion Vital Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Custom Script Infusion Vital Care LLC

  • Community/Retail Pharmacy
  • Hurricane, WV
  • NPI 1801119110
  NPD tax ID

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1104227602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3738 TEAYS VALLEY RD STE C",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269705",
            "telephone_number": "130-473-3378",
            "fax_number": "130-473-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3738 TEAYS VALLEY RD STE C",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269705",
            "telephone_number": "130-473-3378",
            "fax_number": "130-473-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM SCRIPT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "BEAVER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "RESPIRATORY THERAPIST",
        "authorized_official_telephone_number": "13047333784",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Crytzer
• Michele Marie Cunningham, CPHT
• Steven Everett Cunningham, RPH
• Custom Script Infusion Vital Care LLC
• Custom Script Infusion Vital Care LLC
• Bailey Kathryn D'Antoni, MA, LPC
• Tara Leanne Daniels, CRNA
• Daquest Care Transport LTD Co.
• Kiera Daugherty, DPT, PT
• Heather Davenport, RN

• Oxygen Equipment & Supplies (DME) in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Oxygen Equipment & Supplies (DME) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.