Organization
CUSTOMIZED MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BERNTSEN (PRESIDENT)
(203) 331-2098
Entity
Organization
Contact information
Practice address
181 MAIN ST, SUITE 1A, NORWALK, CT 06851-3626
(203) 331-2098
Mailing address
32 EDINBURG LN, TRUMBULL, CT 06611-1065
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
CSW0003398
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW0003398
DEPT. OF CONSUMER PROTECTION
CT
Enumeration date
12/29/2014
Last updated
12/29/2014
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