Custom Healthcare Llc | |
1540 Gober Rd Bishop GA 30621-1685 | |
(706) 207-1039 | |
Not Available |
Full Name | Custom Healthcare Llc |
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Speciality | Clinic/center - Multi-specialty |
Location | 1540 Gober Rd, Bishop, Georgia |
Authorized Official Name and Position | Troy Allen Heidesch (CEO/ PROVIDER) |
Authorized Official Contact | 7062071039 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Custom Healthcare Llc 1540 Gober Rd Bishop GA 30621-1685 Ph: (706) 207-1039 | Custom Healthcare Llc 1540 Gober Rd Bishop GA 30621-1685 Ph: (706) 207-1039 |
NPI Number | 1316268105 |
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Provider Enumeration Date | 06/16/2010 |
Last Update Date | 06/16/2010 |
Identifier | Type | State | Issuer |
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1316268105 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |