| Customized Medication, LLC | |
|
541 Roske Dr Ste E Elkhart IN 46516-9323 | |
| (574) 522-1940 | |
| (574) 522-1990 |
| Full Name | Customized Medication, LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 541 Roske Dr Ste E, Elkhart, Indiana |
| Authorized Official Name and Position | Richard Sargent (OWNER) |
| Authorized Official Contact | 5745221940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Customized Medication, LLC 58147 Diener Dr Goshen IN 46528-7723 Ph: (574) 522-1940 | Customized Medication, LLC 541 Roske Dr Ste E Elkhart IN 46516-9323 Ph: (574) 522-1940 |
| NPI Number | 1497916548 |
|---|---|
| Provider Enumeration Date | 06/21/2008 |
| Last Update Date | 04/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497916548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 60005663A (Indiana) | Primary |
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