Provider Demographics
NPI:1033286125
Name:AAA DISCOUNT MOBILITY LLC
Entity Type:Organization
Organization Name:AAA DISCOUNT MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:FARRETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-947-0203
Mailing Address - Street 1:4930 E MAIN ST
Mailing Address - Street 2:SUITE 18
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8000
Mailing Address - Country:US
Mailing Address - Phone:480-947-0203
Mailing Address - Fax:480-324-0203
Practice Address - Street 1:4930 E MAIN ST
Practice Address - Street 2:SUITE 18
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8000
Practice Address - Country:US
Practice Address - Phone:480-947-0203
Practice Address - Fax:480-324-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20127625332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5876000001Medicare NSC