Provider Demographics
NPI:1033456512
Name:KOHLBRECHER MOBILITY LLC
Entity Type:Organization
Organization Name:KOHLBRECHER MOBILITY LLC
Other - Org Name:101 MOBILITY OF ST. LOUIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:KOHLBRECHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-258-1766
Mailing Address - Street 1:831 WESTWOOD INDUSTRIAL PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-4584
Mailing Address - Country:US
Mailing Address - Phone:314-258-1766
Mailing Address - Fax:
Practice Address - Street 1:831 WESTWOOD INDUSTRIAL PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-4584
Practice Address - Country:US
Practice Address - Phone:314-258-1766
Practice Address - Fax:866-256-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO320900000XMedicaid