Provider Demographics
NPI:1073620670
Name:SOUTHWEST MOBILITY INC
Entity Type:Organization
Organization Name:SOUTHWEST MOBILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-654-2292
Mailing Address - Street 1:4406 E MAIN STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205
Mailing Address - Country:US
Mailing Address - Phone:480-654-2292
Mailing Address - Fax:480-654-2314
Practice Address - Street 1:4406 E MAIN STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205
Practice Address - Country:US
Practice Address - Phone:480-654-2292
Practice Address - Fax:480-654-2314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ111609Medicaid
AZAZ0272250OtherBLUE CROSS
AZ111609Medicaid