1053384602 NPI number — NATIONAL SEATING & MOBILITY, INC.

Table of content: (NPI 1053384602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053384602 NPI number — NATIONAL SEATING & MOBILITY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL SEATING & MOBILITY, 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:
1053384602
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5959 SHALLOWFORD RD
Provider Second Line Business Mailing Address:
SUITE 443
Provider Business Mailing Address City Name:
CHATTANOOGA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37241-2245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-756-2268
Provider Business Mailing Address Fax Number:
423-266-9690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1936 SOUTH LYNHURST DRIVE
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46241-4636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-487-0758
Provider Business Practice Location Address Fax Number:
800-240-5892
Provider Enumeration Date:
02/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MATUKEWICZ
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
423-756-2268

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: 0996598 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100194330A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 56393 . This is a "IN CHILDREN'S SPECIAL HEALTH CARE SERVICES" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200099080D . This is a "INDIANA WAIVER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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