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Organization

CUSTOM HEALTHCARE, LLC

Active
Other names
Phoenix Rehab & Mobility
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES ROGERS (CEO)
(423) 697-0057
Entity
Organization

Contact information

Practice address
48 MORRISON LN, RINGGOLD, GA 30736-7277
(706) 935-2352
Mailing address
3700 BRAINERD RD, CHATTANOOGA, TN 37411-3603
(423) 697-0057

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
332BC3200X
Customized Equipment (DME)
Primary
335E00000X
Prosthetic/Orthotic Supplier

Other

Enumeration date
10/11/2018
Last updated
03/08/2019
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