Heritage Pharmacy Group LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HERITAGE PHARMACY GROUP LLC

Doing business as

Customrx Pharmacy

Practice address

10099 Weddington Rd Ext, Ste 120
Ste 120
Concord, NC 28027

Phone

(432) 553-0051

NPI assigned

Apr 23, 2018

Last updated

Jan 16, 2026By 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

Ryan Delvaux

Title

Managing Member/Owner

Phone

(631) 374-1911

Specialties & licenses 1

Addresses

Other names 1

• CUSTOMRX PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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.

• Tho Nguyen

  • Pharmacist
  • Charlotte, NC
  • NPI 1447748512
  NPD (past)

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1720576085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10099 WEDDINGTON RD EXT, STE 120",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10099 WEDDINGTON RD EXT, STE 120",
            "address_2": "STE 120",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28027",
            "telephone_number": "432-553-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PHARMACY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "DELVAUX",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGING MEMBER/OWNER",
        "authorized_official_telephone_number": "631-374-1911"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUSTOMRX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lucas Hendzel, PT
• Stacy Henrickson, NP
• Sara E. Henry, MD
• Her Diagnostics, LLC
• Heritage Healthcare, Inc (Heritage Rehab & Fitness, LLC)
• Allison McGowan Hermans, COTA/L
• Julia Anne Hermansen, BCBA, LBA
• Sylvia Hernandez, OD
• Yulissa Moran Hernandez, MSW, LCSWA
• Jessica Herrera

• Community/Retail Pharmacy in Concord, NC
• Providers in Concord, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.