CUSTOM PHARMACY INNOVATIONS INC NPI 1073606240

NPI Details

CUSTOM PHARMACY INNOVATIONS INC is a community/retail pharmacy pharmacy in Nicoma Park, OK. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. CUSTOM PHARMACY INNOVATIONS INC NPI is 1073606240. The provider is registered as an organization entity type.

The provider's business location address is:

10911 NE 23RD
NICOMA PARK, OK
ZIP 73066
Phone: (405) 769-8585
Fax: (405) 769-8787

The provider's authorized official is John Blomgren .
The authorized official title is President and has the following contact phone number (405) 769-8585.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Administration of pneumococcal vaccine (HCPCS:G0009)
• Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
• Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; first dose (HCPCS:0011A)
• Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose (HCPCS:0012A)
• Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)

The enumeration date for this NPI number is 10/2/2006 and was last updated on 4/24/2018.

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:

Other Identifiers

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