NPI age
15 years
Enumerated 2011-02-09
● Active Type 2 · Organization
Customedica Pharmacy Inc
Customedica Pharmacy Inc is 1 of 17 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Plus 3 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Afshar
Cheif Pharmacist
Last NPPES update
2016-08-17
Source: monthly bulk 2026-05
How this organization compares
Across 17 active pharmacy providers in Idaho.
NPI age
15 years
↑ 11 yr above median
Practice locations
1
0 secondary on file
Subspecialties
3
In the 29% of peers with subspecialties
NPI lifetime · 2011 → 2026
2011-02Enumerated in NPPES
2011
2026
Where they practice
Primary practice location
149 W State St Ste 101
Eagle, ID 836164911
Mailing address
149 W State St, Suite 101
Eagle, ID 836164901
Authorized official
Shah Afshar, PHARM.D.
Cheif Pharmacist
📞 2089398008
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Alex Wald Pharmacist NPI 1295101400
- Alyssa Zibrowski, PHARM.D. Pharmacist NPI 1447710728
Specialties
-
Pharmacy PrimaryA 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...
-
PharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
-
PharmacyA 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...
-
PharmacyA pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 2128455 | PK |
| 05 (ID) | 806251800 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
CUSTOMEDICA COMPOUNDING CENTER
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.