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
410 DROMEDARY ST, WOODBURY, GA 30293-3560
(770) 450-4227
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
—
—
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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