Custom Compounding LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PCY1921 Issued in CT

Legal business name

CUSTOM COMPOUNDING LLC

Practice address

3 Maple St
Kent, CT 06757-1711

Phone

(866) 606-0440

NPI assigned

Feb 21, 2011

Last updated

Feb 21, 2011By 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. Peter B Daprile, RPH, MBA

Title

Member

Phone

(866) 606-0440

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298246400000",
    "number": "1376840785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MAPLE ST",
            "address_2": "PO BOX 632",
            "city": "KENT",
            "state": "CT",
            "postal_code": "067571711",
            "telephone_number": "866-606-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MAPLE ST",
            "city": "KENT",
            "state": "CT",
            "postal_code": "067571711",
            "telephone_number": "866-606-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM COMPOUNDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-21",
        "last_updated": "2011-02-21",
        "status": "A",
        "authorized_official_last_name": "DAPRILE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "866-606-0440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH, MBA"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CT",
            "license": "PCY1921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Burlinson
• Samantha K Case, LMSW
• Annupma Chandra, RPH
• Danielle Rita Colopy, LPC, LADC, ATR
• Anne Corey
• Peter B.C. Daprile, R.PH
• Arlin Deboer, PT
• Laura Deboer, PT
• Douglas a. Finch, MD, LLC
• Janet Buch Downes, MSW

• Compounding Pharmacy in Kent, CT
• Providers in Kent, CT by specialty
• Compounding Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; 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.