Provider Demographics
NPI:1013045848
Name:MOBILITY PRODUCTS CORP
Entity Type:Organization
Organization Name:MOBILITY PRODUCTS CORP
Other - Org Name:MOPRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:REAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-472-0707
Mailing Address - Street 1:3232 ERIE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1204
Mailing Address - Country:US
Mailing Address - Phone:315-472-0707
Mailing Address - Fax:315-472-8088
Practice Address - Street 1:3232 ERIE BLVD E
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-1204
Practice Address - Country:US
Practice Address - Phone:315-472-0707
Practice Address - Fax:315-472-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02472282Medicaid
NY4753630001Medicare NSC