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CUSTOM RX LLC
NPI 1477029577
Pharmacy - Community/Retail Pharmacy in Melba, ID

Active since October 17, 2018

NPPES record last updated: October 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Custom Rx Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOM RX LLC (NPI 1477029577), doing business as Custom Rx Pharmacy Melba, is a healthcare organization registered as a community/retail pharmacy in Melba, Idaho and active in the NPI registry since October 2018. The organization lists Travis Walthall, Pic/managing Member, as its authorized official.

NPPES Registry Identity

NPI1477029577
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameCUSTOM RX LLC
Location Address112 4TH STMelba, ID 83641-5197
Mailing AddressPo Box 246Kuna, ID 83634-0246 · (208) 922-4400 · Fax (208) 922-4499
Phone(208) 495-9809
Organization SubpartYes
Authorized OfficialTravis WalthallPic/managing Member · (208) 922-4400
Enumeration DateOctober 17, 2018
✔ NPI 1477029577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
112 4TH ST, Melba, ID 83641
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Other Names 1

Doing Business AsCustom Rx Pharmacy Melba

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CRX HEALTH SERVICES LLC
Pharmacy (Community/Retail Pharmacy)
112 4TH ST
MELBA, ID 83641
Canyon County (208) 495-9809

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Rx LLC's NPI number?

The NPI number for Custom Rx LLC is 1477029577. It was assigned to this organization in the NPPES registry on October 17, 2018. The provider is doing business as Custom Rx Pharmacy Melba.

Where is Custom Rx LLC located?

Custom Rx LLC is located at 112 4th St, Melba, ID 83641. The listed phone number is (208) 495-9809.

What is Custom Rx LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does Custom Rx LLC accept?

Health plans from Medica and Moda Health Plan, Inc. list Custom Rx LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Custom Rx LLC was last updated on October 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.