Provider Demographics
NPI:1093184293
Name:MOBILITY ACCESS,LLC
Entity Type:Organization
Organization Name:MOBILITY ACCESS,LLC
Other - Org Name:101MOBILITY OF CONNECTICUT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:860-904-6653
Mailing Address - Street 1:485 NEW PARK AVE STE F3
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1333
Mailing Address - Country:US
Mailing Address - Phone:860-904-6653
Mailing Address - Fax:860-216-4197
Practice Address - Street 1:485 NEW PARK AVE STE F3
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-1333
Practice Address - Country:US
Practice Address - Phone:860-904-6653
Practice Address - Fax:860-216-4197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies