Custom Compounding Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0000003295 Issued in TN

Legal business name

CUSTOM COMPOUNDING PHARMACY LLC

Doing business as

Custom Compounding Phy LLC

Practice address

3816 Ringgold Rd
Chattanooga, TN 37412-1640

Phone

(423) 629-0353

Fax

(423) 629-9646

NPI assigned

Feb 2, 2007

Last updated

Jul 20, 2007By 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

Joe Musick, RPH

Title

Pharmacist

Phone

(423) 629-0353

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• CUSTOM COMPOUNDING PHY LLC Doing business as

Locations

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1417095407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 RINGGOLD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374121640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 RINGGOLD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374121640",
            "telephone_number": "423-629-0353",
            "fax_number": "423-629-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "MUSICK",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "423-629-0353",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "0000003295",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4432061",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4432061",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUSTOM COMPOUNDING PHY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Brimer Curtis, MSPT
• Laura Curtis, PA
• Nicole Curtis, OTD, OTR/L
• Anne Cushing, PHD, NCC, LPC
• Lacy E Cushman, FNP-C
• Custom Healthcare (PPS Infusion Pharmacy)
• Custom Healthcare, LLC (PPS Orthotic & Prosthetic Services)
• Nicholas Harley Cutchens, MD
• Leah Kathryn Cuthbertson, RN
• Amanda Elizabeth Cutting, OTR/L

• Community/Retail Pharmacy in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.