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
1101 OLD CREEK RD STE A1, ATHENS, GA 30607-1090
(706) 850-0453
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
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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