Provider Demographics
NPI:1053415380
Name:PEOPLE'S CUSTOM RX & CLINICAL CARE CENTER, LLC
Entity type:Organization
Organization Name:PEOPLE'S CUSTOM RX & CLINICAL CARE CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:901-682-2273
Mailing Address - Street 1:785 E BROOKHAVEN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4501
Mailing Address - Country:US
Mailing Address - Phone:901-682-2273
Mailing Address - Fax:901-682-4146
Practice Address - Street 1:785 E BROOKHAVEN CIRCLE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4501
Practice Address - Country:US
Practice Address - Phone:901-682-2273
Practice Address - Fax:901-682-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X, 3336C0003X, 3336C0004X, 3336H0001X, 3336L0003X
TN32573336C0004X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4431728OtherNCPDP
TNQ045733Medicaid
TN1154791OtherNATIONAL COMMUNITY PHARM ASSOCIATION
TN37715OtherINTERNATIONAL JOURNAL OF COMPOUNDING TODAY
TN700497OtherAMERICAN PHARMACISTS ASSOCIATION
TN47541OtherINTERNATIONAL JOURNAL OF COMPOUNDING PHARMACIST STAND -
TN1154791OtherNATIONAL COMMUNITY PHARM ASSOCIATION