Provider Demographics
NPI:1104015650
Name:MOBILE HEALTH SOLUTIONS INC
Entity Type:Organization
Organization Name:MOBILE HEALTH SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GERKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-566-1733
Mailing Address - Street 1:121 PINE CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3003
Mailing Address - Country:US
Mailing Address - Phone:386-566-1733
Mailing Address - Fax:386-615-6628
Practice Address - Street 1:121 PINE CREEK TRL
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-3003
Practice Address - Country:US
Practice Address - Phone:386-566-1733
Practice Address - Fax:386-615-6628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLX8134Medicare PIN