MEDICARE: CUSTOM COMMUNICATIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333300000X	Emergency Response System Companies

General Provider Information

NPI Number	:	1053544189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUSTOM COMMUNICATIONS, INC.

Provider Business Mailing Address
First Line	:	1661 GREENVIEW DR SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55902-4215
Country	:	US
Telephone Number	:	507-288-5522
Fax Number	:	507-287-0757

Provider Business Practice Location Address
First Line	:	1661 GREENVIEW DR SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55902-4215
Country	:	US
Telephone Number	:	507-288-5522
Fax Number	:	507-287-0757

Authorized Official
Title or Position	:	CEO
Name	:	MR. LEIGH J JOHNSON
Credential	:
Telephone Number	:	507-288-5522

Provider Enumeration Date	:	08/24/2009
Last Update Date	:	08/24/2009

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