1043474638 NPI number — MOBILITY PLUS INC

Table of content: (NPI 1043474638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043474638 NPI number — MOBILITY PLUS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOBILITY PLUS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043474638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10503 MAUMELLE BLVD STE 3A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72113-6742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-310-7587
Provider Business Mailing Address Fax Number:
877-762-6109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10503 MAUMELLE BLVD STE 3A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72113-6742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-310-7587
Provider Business Practice Location Address Fax Number:
877-762-6109
Provider Enumeration Date:
07/14/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GENTRY
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
501-588-7676

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CFTS0132 . This is a "ABC" identifier . This identifiers is of the category "OTHER".
  • Identifier: CFO02089 . This is a "ABC" identifier . This identifiers is of the category "OTHER".