Custom Brace Shop Inc. in Galesburg - Durable Medical Equipment & Medical Supplies
Custom Brace Shop Inc. - NPI 1306865563
Custom Brace Shop Inc. is a Durable Medical Equipment & Medical Supplies in Galesburg, Illinois. Custom Brace Shop Inc. practices all healthcare services and medical treatments related to Durable Medical Equipment & Medical Supplies. The NPI Number for Custom Brace Shop Inc. is 1306865563. The last update date is 2008-07-11.
Custom Brace Shop Inc.'s current location address is 872 W Dayton St, Galesburg, Illinois. You can contact this provider via phone number 3093445330 and fax number 3093445040. The mailing address for Custom Brace Shop Inc. is 872 W Dayton St, Galesburg, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Custom Brace Shop Inc. |
|---|---|
| Address | 872 W Dayton St, Galesburg, Illinois |
| Phone Number | 3093445330 |
| Fax Number | 3093445040 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Azer Wilson Fakhry |
| Credentials | P.T. |
| Telephone Number | 3093443400 |
NPI Number Detail
| NPI Number | 1306865563 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2008-07-11 |
Provider Mailing Address Detail
| Address | 872 W Dayton St |
|---|---|
| City | Galesburg |
| State | Illinois (IL) |
| Post Code | 614011503 |
| Phone Number | 3093445330 |
| Fax Number | 3093445040 |
Provider's Primary Taxonomy Detail
| Speciality | Durable Medical Equipment & Medical Supplies |
|---|---|
| Taxonomy | 332B00000X |
|
Definition: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 30404878 | IL | CERTIFICATE OF REGISTRATI |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Custom Brace Shop Inc. by the Centers for Medicare & Medicaid Services?
The Custom Brace Shop Inc. has been assigned the NPI (National Provider Identifier) 1306865563 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Custom Brace Shop Inc. is physically located?
The Custom Brace Shop Inc. is physically situated at the following address: 872 W Dayton St, Galesburg, IL, 614011503.
What is Custom Brace Shop Inc.'s area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Custom Brace Shop Inc. is Durable Medical Equipment & Medical Supplies, and the taxonomy code that categorizes this field of expertise is 332B00000X.
On what date was the 1306865563 assigned to Custom Brace Shop Inc.?
The Custom Brace Shop Inc. was issued its 1306865563 on 2006-07-19, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Custom Brace Shop Inc., such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Custom Brace Shop Inc., including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2008-07-11.