1144522830 NPI number — UNITED SEATING AND MOBILITY LLC

Table of content: (NPI 1144522830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144522830 NPI number — UNITED SEATING AND MOBILITY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED SEATING AND MOBILITY LLC
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:
6
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:
1144522830
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
805 BROOK ST STE 402
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKY HILL
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06067-3431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-447-7500
Provider Business Mailing Address Fax Number:
314-447-7830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 N 113TH ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAUWATOSA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226-3210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-762-1300
Provider Business Practice Location Address Fax Number:
414-762-6484
Provider Enumeration Date:
12/01/2010

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
WALTER
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING AND LICENSURE MANAGER
Authorized Official Telephone Number:
314-447-7515

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: UO18667 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1144522830 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com