OrganizationActive
Custom Rx LLC
NPI 1477029577 · Community/Retail Pharmacy · Melba, ID
Custom Rx LLC is a Community/Retail Pharmacy organization in Melba, ID (NPI 1477029577).
Provider details
- NPI number
- 1477029577
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Parent organization
- Custom Rx LLC
- Organization subpart
- Yes
- Authorized official
- Travis Walthall, Pic/Managing Member(208) 922-4400
Specialties & taxonomies
Suppliers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
112 4th St
Melba, ID 83641-5197
Phone: (208) 495-9809
Street-level locationGet directions
Mailing address
Po Box 246
Kuna, ID 83634-0246
Other names (DBA / former)
- Doing business as
- Custom Rx Pharmacy Melba
Registry dates
- Enumerated
- 2018-10-17
- Last updated
- 2018-10-17
Frequently asked questions
- What is Custom Rx LLC's NPI number?
- Custom Rx LLC's National Provider Identifier (NPI) is 1477029577, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Custom Rx LLC?
- Custom Rx LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Custom Rx LLC located?
- Custom Rx LLC's practice location on file with NPPES is 112 4th St, Melba, ID 83641-5197.
- What is Custom Rx LLC's phone number?
- The practice phone number listed in the NPPES registry for Custom Rx LLC is (208) 495-9809.
- Who is the authorized official for Custom Rx LLC?
- The authorized official listed on Custom Rx LLC's NPPES record is Travis Walthall, Pic/Managing Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Custom Rx LLC's NPI active?
- Yes — Custom Rx LLC's NPI (1477029577) is active in the NPPES registry as of the last update on 2018-10-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.