Provider Demographics
NPI:1003846155
Name:MOBILITY INDEPENDENT TRANSPORTATION INC. OF VIRGINIA
Entity Type:Organization
Organization Name:MOBILITY INDEPENDENT TRANSPORTATION INC. OF VIRGINIA
Other - Org Name:M. I. T. S. OF VIRGINIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER/VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-932-7300
Mailing Address - Street 1:2075 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-1741
Mailing Address - Country:US
Mailing Address - Phone:540-932-7300
Mailing Address - Fax:540-941-3517
Practice Address - Street 1:2075 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-1741
Practice Address - Country:US
Practice Address - Phone:540-932-7300
Practice Address - Fax:540-941-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1302830001Medicare ID - Type Unspecified