Provider Demographics
NPI:1114045572
Name:NORTHCOAST MOBILITY
Entity Type:Organization
Organization Name:NORTHCOAST MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-812-2147
Mailing Address - Street 1:5382 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3451
Mailing Address - Country:US
Mailing Address - Phone:888-812-2147
Mailing Address - Fax:888-812-2147
Practice Address - Street 1:5382 OBERLIN AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-3451
Practice Address - Country:US
Practice Address - Phone:888-812-2147
Practice Address - Fax:888-812-2147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH47 075388332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5538320001Medicare NSC