Provider Demographics
NPI:1013374792
Name:JM MOBILITY, LLC
Entity Type:Organization
Organization Name:JM MOBILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACENT
Authorized Official - Middle Name:L
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-904-2719
Mailing Address - Street 1:5301 MCCLANAHAN DR
Mailing Address - Street 2:SUITE A4
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7001
Mailing Address - Country:US
Mailing Address - Phone:501-904-2719
Mailing Address - Fax:501-904-2714
Practice Address - Street 1:5301 MCCLANAHAN DR
Practice Address - Street 2:SUITE A4
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7001
Practice Address - Country:US
Practice Address - Phone:501-904-2719
Practice Address - Fax:501-904-2714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR217176716Medicaid
AR217176716Medicaid