Provider Demographics
NPI:1992011902
Name:CUSTOM HOME ELEVATOR & LIFT CO INC
Entity Type:Organization
Organization Name:CUSTOM HOME ELEVATOR & LIFT CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JON
Authorized Official - Last Name:HAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-583-5910
Mailing Address - Street 1:11431 WILLIAMSON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45241-4215
Mailing Address - Country:US
Mailing Address - Phone:513-583-5910
Mailing Address - Fax:513-583-8807
Practice Address - Street 1:11431 WILLIAMSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45241-4215
Practice Address - Country:US
Practice Address - Phone:513-583-5910
Practice Address - Fax:513-583-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3049865Medicaid