Provider Demographics
NPI:1811148679
Name:CUSTOM LIFTS & ACCESS
Entity type:Organization
Organization Name:CUSTOM LIFTS & ACCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BYERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-842-3505
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-0717
Mailing Address - Country:US
Mailing Address - Phone:423-842-3505
Mailing Address - Fax:423-843-9825
Practice Address - Street 1:1903 BAY POINTE DR
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-3192
Practice Address - Country:US
Practice Address - Phone:423-842-3505
Practice Address - Fax:423-843-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment