North American Custom Laboratories LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

NORTH AMERICAN CUSTOM LABORATORIES LLC

Doing business as

North American Custom Laboratories

Practice address

1736 N Greenville Ave
Richardson, TX 75081-1808

Phone

(214) 390-9990

Fax

(214) 432-8922

NPI assigned

Aug 13, 2014

Organization subpart

No

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

Authorized official

Name

Justin Graves

Title

President/Pic

Phone

(214) 240-6208

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• North American Custom Laboratories Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin Tai Pon, PHARMD

  • Pharmacist
  • Richardson, TX
  • NPI 1790657211
  NPD (past)

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1396144531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 N GREENVILLE AVE",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750811808",
            "telephone_number": "214-390-9990",
            "fax_number": "214-432-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 N GREENVILLE AVE",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750811808",
            "telephone_number": "214-390-9990",
            "fax_number": "214-432-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH AMERICAN CUSTOM LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT/PIC",
        "authorized_official_telephone_number": "214-240-6208"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147457",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North American Custom Laboratories",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Norcross, OTR
• John W Nord, LPC
• Angela Abla Nordin, LPC
• Scott O'Neal Normile, PT
• Dwayne Mitchum Norris
• North Central Dental Services PLLC (Sunrise Dental)
• North Dallas County Homecare LLC (Here for You HomeCare)
• North Dallas Digestive Disease
• North Dallas Ear, Nose, and Throat PA
• North Dallas Epilepsy, PLLC

• Home Infusion Therapy Pharmacy in Richardson, TX
• Providers in Richardson, TX by specialty
• Home Infusion Therapy Pharmacy in Texas

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