The Custom Source Inc is a Prosthetic & Orthotic Supplier (Prosthetic & Orthotic Supplier) in Matthews, North Carolina. It is situated at 1013 Chestnut Ln Ste 120, Matthews and its contact number is 704-893-5457. The authorized person of The Custom Source Inc is Kasey Rolfes
who is Operations Manager of the store and his/her contact number is 704-893-5457. The Custom Source Inc is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Complete Center Profile:
The Custom Source Inc Center speciality, address, contact phone number and fax are as below.
Patients can directly walkin to the Prosthetic/Orthotic center or can call on the below given phone number for appointment.
1013 Chestnut Ln Ste 120, Matthews, North Carolina, 28104-8567
Phone:
704-893-5457
Fax:
704-973-0696
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this store are as below. Person's position and contact details are also mentioned below.
Name:
Kasey Rolfes
Position:
Operations Manager
Contact Number:
704-893-5457
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for The Custom Source Inc center are as mentioned below.
NPI Number:
1114902665
NPI Enumeration Date:
07 Dec, 2005
NPI Last Update On:
21 Jul, 2022
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for The Custom Source Inc are as mentioned below.
Specialization
License Number
State
Status
Primary
Secondary
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
0491E
Other
Bc/bs/nc
7700578
Medicaid
North Carolina
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
The Custom Source Inc 1013 Chestnut Ln Ste 120, Matthews, North Carolina
Zip:
28104-8567
Phone Number:
704-893-5457
Fax Number:
704-973-0696
Patients can reach The Custom Source Inc at 1013 Chestnut Ln Ste 120, Matthews, North Carolina or can call to book an appointment on 704-893-5457. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.
Comments/ Reviews:
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