Custom Medical Services in Roosevelt - Adolescent Medicine
Custom Medical Services - NPI 1669452298
Custom Medical Services is a Adolescent Medicine in Roosevelt, Utah. Custom Medical Services practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for Custom Medical Services is 1669452298. The last update date is 2020-08-22.
Custom Medical Services's current location address is Rr 3 Box 3053, Roosevelt, Utah. You can contact this provider via phone number 4357227704. The mailing address for Custom Medical Services is Rr 3 Box 3053, Roosevelt, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Custom Medical Services |
|---|---|
| Address | Rr 3 Box 3053, Roosevelt, Utah |
| Phone Number | 4357227704 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Pehrson Edwin Steve |
| Credentials | M.D. |
| Telephone Number | 4357227704 |
NPI Number Detail
| NPI Number | 1669452298 |
|---|---|
| Provider Enumeration Date | 2006-01-19 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | Rr 3 Box 3053 |
|---|---|
| City | Roosevelt |
| State | Utah (UT) |
| Post Code | 840669609 |
| Phone Number | 4357227704 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 207Qa0000X |
|
Definition: A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
|
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What is the unique identifier code issued to Custom Medical Services by the Centers for Medicare & Medicaid Services?
The Custom Medical Services has been assigned the NPI (National Provider Identifier) 1669452298. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Custom Medical Services's facilities are geographically located?
The facilities of Custom Medical Services are physically situated at the following location: Rr 3 Box 3053, Roosevelt, UT, 840669609.
What is Custom Medical Services's specialized field of practice, and what is the corresponding taxonomy classification code?
The Custom Medical Services's area of specialization is Adolescent Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Qa0000X.
On what date did Custom Medical Services receive its 1669452298 assignment from the Centers for Medicare & Medicaid Services?
The Custom Medical Services was assigned its 1669452298 on 2006-01-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Custom Medical Services last refreshed?
The information related to the Custom Medical Services, including its address, specialty, and other relevant details, was last updated on 2020-08-22.
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