Larry Andrew Custer, R.PH.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

024244 Issued in MO

Practice address

1925 Breton Rd SE
Suite 202
Grand Rapids, MI 49506-4810

Phone

(616) 252-4757

Fax

(616) 252-0724

NPI assigned

Oct 2, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1730330341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 BRETON RD SE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064810",
            "telephone_number": "616-252-4757",
            "fax_number": "616-252-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 BRETON RD SE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064810",
            "telephone_number": "616-252-4757",
            "fax_number": "616-252-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "LARRY",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MO",
            "license": "024244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Cusenza, CTRS
• Julie Lynn Cusic, LMSW
• Kellee Cusick, LMSW
• Jacqueline R Custer
• Kortne Custer, P.A. -C
• Carey Cutcher, LMSW
• Brian Scott Cutler, DO
• Leah Remi Cutler, LLMSW
• Cutlerville Eyecare, P.C.
• Angelia Josephine Cutts

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.