Organization
CUSTOM FITS O & P SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK CHRISTOPHER THIGPEN CO LCPED (PRESIDENT)
(954) 721-7301
Entity
Organization
Contact information
Practice address
8401 W MCNAB ROAD, TAMARAC, FL 33321
(954) 721-7301
(954) 721-7453
Mailing address
8401 W MCNAB ROAD, TAMARAC, FL 33321
(954) 721-7301
(954) 721-7453
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1047364
CAREPLUS
—
01
—
10582
TOTAL HEALTH CHOICE
—
01
—
3475892
AETNA
—
01
—
50540
NEIGHBORHOOD HEALTH
—
01
—
M2678
BCBS
—
01
—
POS7973523
HMO
—
Enumeration date
11/15/2006
Last updated
08/22/2020
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