NPI age
7 years
Enumerated 2018-10-17
● Active Type 2 · Organization
Subpart
Custom Rx Llc
Custom Rx Llc is 1 of 397 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Walthall
Pic/managing Member
Last NPPES update
2018-10-17
Source: monthly bulk 2026-05
How this organization compares
Across 397 active pharmacy providers in Idaho.
NPI age
7 years
↓ 12 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2018 → 2026
2018-10Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
112 4th St
Melba, ID 836415197
Mailing address
Po Box 246
Kuna, ID 836340246
Authorized official
Travis Walthall, RPH
Pic/managing Member
📞 2089224400
Specialties
-
Pharmacy PrimaryA 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...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Custom Rx Pharmacy Melba
Practice context
Single-site organization. Only one practice location on file.
Subpart of Custom Rx Llc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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