Provider Demographics
NPI:1093743700
Name:BULLDOG MOBILITY SERVICES, INC.
Entity Type:Organization
Organization Name:BULLDOG MOBILITY SERVICES, INC.
Other - Org Name:BULLDOG MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-858-5185
Mailing Address - Street 1:1630 NORTHFIELD DR
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2498
Mailing Address - Country:US
Mailing Address - Phone:317-858-5185
Mailing Address - Fax:317-858-6336
Practice Address - Street 1:1630 NORTHFIELD DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2498
Practice Address - Country:US
Practice Address - Phone:317-858-5185
Practice Address - Fax:317-858-6336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0115812954332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5032290002Medicare ID - Type Unspecified