CUSTOM HEALTHCARE, LLC (NPI# 1588122394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588122394 |
| Entity Type | Organization |
| Organization Name | CUSTOM HEALTHCARE, LLC |
| Practice Address |
1101 Old Creek Rd Ste A1 Athens GA 30607-1090 |
| Mailing Address |
3700 Brainerd Rd Chattanooga TN 37411-3603 |
| Practice Telephone | 7068500453 |
| Mailing Telephone | 4236970057 |
| Mailing Fax Number | 4236489366 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |
| Authorized Official Name | JAMES ROGERS (CEO) |
| Authorized Official Telephone | 4236970057 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| Other Name | Type Code |
|---|---|
| Phoenix Rehab & Mobility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366900391 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 410 Dromedary St, Woodbury, GA 30293-3560 | 2019-03-08 |
| 1326511643 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 110 Palmetto Pkwy, Belton, SC 29627-2126 | 2019-01-09 |
| 1285109645 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 48 Morrison Ln, Ringgold, GA 30736-7277 | 2018-10-11 |
| 1083195663 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 902 12th St Ste B, Phenix City, AL 36867-5827 | 2018-08-22 |
| 1538437215 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 201 Center Park Dr Ste 1000, Knoxville, TN 37922-2105 | 2011-12-08 |
| 1770863532 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 806 Ulrich Ave, Louisville, KY 40219-1846 | 2011-08-25 |
| 1952451296 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2150 N Ocoee St Ste C, Cleveland, TN 37311-3936 | 2007-01-11 |
| 1093017642 | Custom Healthcare, LLC | Prosthetic/Orthotic Supplier | 1508 N Thornton Ave, Ste 104, Dalton, GA 30720-8516 | 2010-12-01 |
| 1730481383 | Custom Healthcare, LLC | Prosthetic/Orthotic Supplier | 2400 E Andrew Johnson Hwy, Greeneville, TN 37745-0948 | 2010-12-01 |
| 1275583783 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2006-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | CUSTOM HEALTHCARE, LLC | 3700 Brainerd Rd, Chattanooga, TN 37411 |
| Street Address |
1101 OLD CREEK RD STE A1 |
| City | ATHENS |
| State | GA |
| Zip Code | 30607-1090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972850055 | Junaid Nasir | Internal Medicine | 5105 Jefferson Rd Ste B, Athens, GA 30607 | 2012-08-08 |
| 1942588918 | Gustavo Figueiredo Marcondes Westin | Internal Medicine | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2011-07-25 |
| 1124164421 | Martin John Simmons | Dentist | 3380 Old Jefferson Road, Athens, GA 30607 | 2007-01-30 |
| 1518063338 | The Center for Plastic & Reconstructive Surgery, P.C. | Clinic/Center | 3320 Old Jefferson Rd., Building 100, Athens, GA 30607 | 2006-09-16 |
| 1730173352 | Mohan N Iyer | Ophthalmology | 2705 Jefferson Rd., Athens, GA 30607 | 2005-09-09 |
| 1669473245 | Angela G Stiles | Internal Medicine | 3320 Old Jefferson Road, Bldg 200 Ste A, Athens, GA 30607 | 2005-08-09 |
| 1326691171 | Teresa Rosser | Nurse Practitioner | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2019-07-22 |
| 1124501184 | Anna Cauthen Mcfather | Physician Assistant | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-09-14 |
| 1013498849 | Mary Rougeau Browning | Physician Assistant | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-08-29 |
| 1073092334 | Katelyn Taylor Gillespie | Nurse Practitioner | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-08-08 |
| Find all providers in zip 30607 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255497939 | Sleep Right | Durable Medical Equipment & Medical Supplies | 702 S Palestine St, Athens, TX 75751-3325 | 2006-12-28 |
| 1487738860 | Gaitway Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 109 N Marion St, Athens, AL 35611-2537 | 2006-10-24 |
| 1982139093 | United Seating and Mobility LLC | Durable Medical Equipment & Medical Supplies | 1901 S Palestine St, Athens, TX 75751-5701 | 2017-04-26 |
| 1629250329 | James D. Dillard, Od, PC | Durable Medical Equipment & Medical Supplies | 511 Gaines School Rd, Athens, GA 30605-3125 | 2007-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163228 | Juanetta Barnes | Durable Medical Equipment & Medical Supplies | 2597 Thorngate Way, Acworth, GA 30101-8837 | 2020-08-06 |
| 1952919136 | Aklor Inc | Durable Medical Equipment & Medical Supplies | 2310 Parklake Dr Ne Ste 135, Atlanta, GA 30345-2913 | 2020-07-14 |
| 1285254656 | Kinetic Prosthetics & Medical Supply | Durable Medical Equipment & Medical Supplies | 3595 Hiram Douglasville Hwy Ste 102, Hiram, GA 30141-4963 | 2020-04-25 |
| 1215569843 | Jessi'ca Coley | Durable Medical Equipment & Medical Supplies | 451 Brookview Dr Ste A, Riverdale, GA 30274-7206 | 2020-02-11 |
| 1497387260 | Ogles Oxygen, LLC | Durable Medical Equipment & Medical Supplies | 5901 Goshen Springs Rd Ste G, Norcross, GA 30071-3506 | 2020-02-10 |
| 1982248969 | National Seating & Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 4406 Mercer University Drive, Suite D, Macon, GA 31210-5608 | 2019-11-01 |
| 1548816283 | Daniel Arbuckle | Durable Medical Equipment & Medical Supplies | 2304 Pierce Way, Buford, GA 30519-2293 | 2019-08-16 |
| 1700438587 | Evelyn Ray LLC | Durable Medical Equipment & Medical Supplies | 12570 Lakeside Pkwy, Fayetteville, GA 30215-4002 | 2019-07-12 |
| 1073174603 | Freedom Mobility Center, Inc. | Durable Medical Equipment & Medical Supplies | 4717 Us Highway 80 E Ste 7a, Savannah, GA 31410-2943 | 2019-06-25 |
| 1790258226 | Ariana Sade Jones | Durable Medical Equipment & Medical Supplies | 1015 Casa Dr, Clarkston, GA 30021-1109 | 2019-01-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.