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CUSTOM HEALTHCARE LLC NPI 1275583783


NPI Information

NPI: 1275583783
Provider Name: CUSTOM HEALTHCARE, LLC

Doing Business As: PPS ORTHOTIC & PROSTHETIC SERVICES

Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
3700 BRAINERD RD
CHATTANOOGA, TN
ZIP 37411
Phone: (423) 697-0057
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CUSTOM HEALTHCARE, LLC is a prosthetic orthotic supplier in Chattanooga, TN. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. CUSTOM HEALTHCARE, LLC NPI is 1275583783. The provider is registered as an organization entity type.
The provider Is Doing Business As Pps Orthotic & Prosthetic Services.

The provider's business location address is:

3700 BRAINERD RD
CHATTANOOGA, TN
ZIP 37411-603
Phone: (423) 697-0057
Fax: (423) 648-9366

The provider's authorized official is James C Rogers .
The authorized official title is Ceo and has the following contact phone number (423) 697-0057.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 3/20/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies1036TENNESSEENo
2332BC3200XDurable Medical Equipment & Medical SuppliesCustomized Equipment1036TENNESSEENo
3332BX2000XDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies3347TENNESSEENo
4335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000973794CMEDICAIDGEORGIA
205130009MEDICAIDMISSISSIPPI
31455062MEDICAIDTENNESSEE
47100162230MEDICAIDKENTUCKY
5003113634AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.