The Custom Source Inc
Prosthetic/orthotic Supplier
1013 Chestnut Ln Ste 120, Matthews
North Carolina, 28104-8567
704-893-5457 704-973-0696
The Custom Source Inc is a Prosthetic/orthotic Supplier in Matthews, North Carolina. It is located at 1013 Chestnut Ln Ste 120, Matthews and it's customer support contact number is 704-893-5457. The authorized person of The Custom Source Inc is Kasey Rolfes, DHA, ATC who is Operations Manager of this DME and his contact number is 704-893-5457.
The Custom Source Inc is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
DME Supplier Details:
The Custom Source Inc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | The Custom Source Inc |
| Type: | Prosthetic/orthotic Supplier |
| Location: | 1013 Chestnut Ln Ste 120, Matthews,
North Carolina, 28104-8567 |
| Phone: | 704-893-5457 |
| Fax: | 704-973-0696 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Kasey Rolfes |
| Credentials: | DHA, ATC |
| Position: | Operations Manager |
| Contact Number: | 704-893-5457 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1114902665 |
| NPI Enumeration Date: | 07 Dec, 2005 |
| NPI Last Update On: | 21 Jul, 2022 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for The Custom Source Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Prosthetic/orthotic Supplier | | | Primary | |
| Orthotist | | | Secondary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 0491E | Other | | Bc/bs/nc |
| 7700578 | Medicaid | North Carolina | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1013 Chestnut Ln Ste 120,
Matthews, North Carolina |
| Zip: | 28104-8567 |
| Phone Number: | 704-893-5457 |
| Fax Number: | 704-973-0696 |
Patients can reach The Custom Source Inc at
1013 Chestnut Ln Ste 120, Matthews, North Carolina or can
call on customer care at 704-893-5457.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 February, 2026.