Organization
CUSTOM HEALTHCARE, LLC
Active
Other names
Phoenix Rehab & Mobility
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES C ROGERS (CEO)
(423) 697-0057
Entity
Organization
Contact information
Practice address
902 12TH ST STE B, PHENIX CITY, AL 36867-5827
(334) 560-5777
(423) 648-9366
Mailing address
3700 BRAINERD RD, CHATTANOOGA, TN 37411-3603
(423) 697-0057
(423) 648-9366
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1511
AL
332BC3200X
Customized Equipment (DME)
Primary
1511
AL
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
08/22/2018
Last updated
03/08/2019
About Stedi
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