CUSTOM HEALTHCARE LLC NPI 1366900391

NPI Information

NPI: 1366900391
Provider Name: CUSTOM HEALTHCARE, LLC

Doing Business As: PHOENIX REHAB & MOBILITY

Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
410 DROMEDARY ST
WOODBURY, GA
ZIP 30293
Phone: (770) 450-4227
Get Directions

CUSTOM HEALTHCARE, LLC is a customized equipment durable medical equipment medical supplies in Woodbury, GA. CUSTOM HEALTHCARE, LLC NPI is 1366900391. The provider is registered as an organization entity type.
The provider Is Doing Business As Phoenix Rehab & Mobility.

The provider's business location address is:

410 DROMEDARY ST
WOODBURY, GA
ZIP 30293-560
Phone: (770) 450-4227

The provider's authorized official is James 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 3/8/2019 and was last updated on 3/8/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			Yes

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: 4/28/2024

NPI Synchronization or Removal

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