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DURAMED HEALTHCARE INC NPI 1053370932


NPI Information

NPI: 1053370932
Provider Name: DURAMED HEALTHCARE INC

Doing Business As: CUSTOM PRESCRIPTION SHOPPE

Classification: Pharmacy - 3336C0004X
Entity Type: Organization

Specialization: Compounding Pharmacy

Address:
1543 15 STREET
AUGUSTA, GA
ZIP 30901
Phone: (706) 737-3955
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DURAMED HEALTHCARE INC is a compounding pharmacy pharmacy in Augusta, GA. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. DURAMED HEALTHCARE INC NPI is 1053370932. The provider is registered as an organization entity type.
The provider Is Doing Business As Custom Prescription Shoppe.

The provider's business location address is:

1543 15 STREET
AUGUSTA, GA
ZIP 30901
Phone: (706) 737-3955
Fax: (706) 737-6323

The provider's authorized official is Eric Holgate .
The authorized official title is President and has the following contact phone number (706) 737-3955.

The enumeration date for this NPI number is 3/21/2006 and was last updated on 12/30/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0004XPharmacyCompounding PharmacyPHRE007052GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10184210001MEDICARE ID-TYPE UNSPECIFIED
2000398461AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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