Organization Active NPI

Custom Tecnhology Co., Inc.

  • Durable Medical Equipment & Medical Supplies
  • Yakima, WA
National Provider Identifier
1801033758
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
600623656 Issued in WA
Legal business name
CUSTOM TECNHOLOGY CO., INC.
Practice address
460 McLaughlin Rd
Yakima, WA 98908-9659
Phone
(509) 965-3333
Fax
(509) 965-9309
NPI assigned
Jan 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
B Robert Bader
Title
President
Phone
(509) 965-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 600623656 WA Primary

Addresses

Primary practice location

460 McLaughlin Rd
Yakima, WA 98908-9659

Mailing address

460 McLaughlin Rd
Yakima, WA 98908-9659
Phone (509) 965-3333

Other identifiers 1

IdentifierTypeStateIssuer
1202090OtherFLPMSI

National Provider Directory

National Provider Directory

Locations

460 McLaughlin Rd
Yakima, WA 98908
Phone (509) 965-3333

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231891200000",
    "number": "1801033758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 MCLAUGHLIN RD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989089659",
            "telephone_number": "509-965-3333",
            "fax_number": "509-965-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MCLAUGHLIN RD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989089659",
            "telephone_number": "509-965-3333",
            "fax_number": "509-965-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM TECNHOLOGY CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A",
        "authorized_official_last_name": "BADER",
        "authorized_official_first_name": "B",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-965-3333"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "600623656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMSI",
            "identifier": "1202090",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.