Organization
KUSTOM MADE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICE COATES (CEO)
(248) 890-9660
Entity
Organization
Contact information
Practice address
21841 KENOSHA ST, OAK PARK, MI 48237-2651
(248) 890-9660
Mailing address
21841 KENOSHA ST, OAK PARK, MI 48237-2651
(248) 890-9660
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962840124
NPI
—
Enumeration date
03/13/2022
Last updated
12/29/2025
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