Provider Demographics
NPI:1689792459
Name:CUSTOM SPECIALTIES & SUPPLY, INC.
Entity Type:Organization
Organization Name:CUSTOM SPECIALTIES & SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:RINK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:504-834-3000
Mailing Address - Street 1:3233 25TH ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6011
Mailing Address - Country:US
Mailing Address - Phone:504-834-3000
Mailing Address - Fax:504-834-3276
Practice Address - Street 1:3233 25TH ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6011
Practice Address - Country:US
Practice Address - Phone:504-834-3000
Practice Address - Fax:504-834-3276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies