Provider Demographics
NPI:1063835718
Name:AMERICAN MOBILITY COMPANY LLC
Entity Type:Organization
Organization Name:AMERICAN MOBILITY COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:ILCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-370-0169
Mailing Address - Street 1:5223 KLOCKNER DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-4336
Mailing Address - Country:US
Mailing Address - Phone:804-716-7764
Mailing Address - Fax:804-716-7767
Practice Address - Street 1:5223 KLOCKNER DR
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-4336
Practice Address - Country:US
Practice Address - Phone:804-716-7764
Practice Address - Fax:804-716-7767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment