Custom Medication and Compliance Specialists Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CUSTOM MEDICATION AND COMPLIANCE SPECIALISTS INC

Doing business as

CMC Pharmacy

Practice address

18 New Airport Rd
Ste C
Lagrange, GA 30240-1410

Phone

(706) 884-2843

Fax

(706) 884-8123

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ebell Hsieh, PHARM D

Title

Pharmacist-in-Charage

Phone

(706) 884-2843

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CMC Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1639186265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 NEW AIRPORT RD",
            "address_2": "STE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302401410",
            "telephone_number": "706-884-2843",
            "fax_number": "706-884-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 NEW AIRPORT RD",
            "address_2": "STE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302401410",
            "telephone_number": "706-884-2843",
            "fax_number": "706-884-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM MEDICATION AND COMPLIANCE SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "HSIEH",
        "authorized_official_first_name": "EBELL",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARAGE",
        "authorized_official_telephone_number": "706-884-2843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE010299",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098311415A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016320",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eric Alvin Crouch, DC
• Brittain Skylar Crowe
• Deborah Belinda Culpepper
• Shatevia S Culpepper, MS, LAPC
• James Anfernee Cutts, PA-C
• Verna Fay Daley-Evans, RN
• Brandi B Daniel, PA
• Maria Ann Daniel, NP
• Michele Daniel

• Community/Retail Pharmacy in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.