Custom Compounds Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201002286 Issued in VA

Legal business name

CUSTOM COMPOUNDS INC

Doing business as

HAGUE PHARMACY

Practice address

400 Gresham Dr
Norfolk, VA 23507-1901

Phone

(757) 622-0222

Fax

(757) 623-9010

NPI assigned

Jul 14, 2006

Organization subpart

No

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

Authorized official

Name

Gino Bortoluzzi, RPH

Title

Owner

Phone

(757) 622-0222

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• HAGUE PHARMACY Doing business as

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1447276571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071901",
            "telephone_number": "757-622-0222",
            "fax_number": "757-623-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071901",
            "telephone_number": "757-622-0222",
            "fax_number": "757-623-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM COMPOUNDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "BORTOLUZZI",
        "authorized_official_first_name": "GINO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-622-0222",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201002286",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4808222",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8515999",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAGUE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Demetre Alexander Curry, LPC
• Natasha Nichole Curry, L.C.S.W.
• Cecelia Kathleen Curtis, MPA, PA-C
• Kiera Curtis, CD(DONA)
• Rachel Loring Cushion, D.O.
• Clifford Armstrong Cutchins V, M.D.
• Luke Cutherell, M.D.
• Kristin Barton Cuthriell, L.C.S.W., M.S.W.
• Danielle Cutler
• Shannon Cutshall, PHD, LCP

• Community/Retail Pharmacy in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.