CUSTOM HEALTHCARE (NPI# 1891868204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891868204 |
| Entity Type | Organization |
| Organization Name | CUSTOM HEALTHCARE |
| Other Organization Name | PPS INFUSION PHARMACY |
| Practice Address |
6227 Lee Highway Suite I Chattanooga TN 37421 |
| Mailing Address |
3700 Brainerd Rd Chattanooga TN 37411-3603 |
| Practice Telephone | 4238939335 |
| Practice Fax Number | 4238939336 |
| Mailing Telephone | 4236970057 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2019-03-08 |
| Authorized Official Name | WANDA S KEY (PRESIDENT OF OPERATIONS) |
| Authorized Official Telephone | 4236970057 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251F00000X | Home Infusion | 73387 | TN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1452932 | 05 |
| Other Name | Type Code |
|---|---|
| PPS Infusion Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CUSTOM HEALTHCARE SOLUTIONS LLC | 228 East 45th Street, 12th Fl, New York, Ny 10017 |
| Virginia Business Entities | CUSTOM HEALTHCARE SYSTEMS INC. | 4205 Eubank Road, Richmond, Virginia 23231 |
| Virginia Business Entities | Custom Healthcare Systems of Virginia LLC | 5505 Robin Hood Rd Ste B, Norfolk, Virginia 23513-2423 |
| Street Address |
6227 LEE HIGHWAY SUITE I |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| Taxonomy Code | 251F00000X |
| Grouping | Agencies |
| Classification | Home Infusion |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545494 | Option Care Infusion Services, LLC | Home Infusion | 624 Grassmere Park Ste 22, Nashville, TN 37211-3671 | 2020-10-12 |
| 1700493087 | Infusion Partners, LLC | Home Infusion | 1680 Century Center Pkwy Ste 9, Memphis, TN 38134-8827 | 2020-09-30 |
| 1033726872 | Knoxville Home Therapies LLC | Home Infusion | 3201 Henson Rd Ste 101, Knoxville, TN 37921-5346 | 2020-09-25 |
| 1194348300 | Picc Infusion Care Company LLC | Home Infusion | 5 Park Ln, Hendersonville, TN 37075-9682 | 2020-05-21 |
| 1538524392 | Care Angles Home Health Care | Home Infusion | 676 Holland Ridge Dr, La Vergne, TN 37086-4266 | 2015-12-22 |
| 1740606847 | Clark Builders | Home Infusion | 860 Bear Creek Rd, Pinson, TN 38366-1955 | 2014-03-13 |
| 1477864031 | P3 Compounding, LLC | Home Infusion | 8848 Cedar Springs Ln, Suite 100, Knoxville, TN 37923-5415 | 2010-06-29 |
| 1811030331 | Caremax Pharmacy of Loudon, Inc | Home Infusion | 413 S Gay St Ste 203, Knoxville, TN 37902-1104 | 2007-02-14 |
| 1366432122 | Jackson-madison County General Hospital | Home Infusion | 1061 West Forest Avenue, Jackson, TN 38301-3879 | 2005-10-24 |
| 1023004363 | Blount Memorial Hospital, Inc. | Home Infusion | 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 2005-09-22 |
| Find all providers with the same taxonomy | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.