Provider Demographics
NPI:1114347911
Name:SENIOR MOBILITY, LLC
Entity Type:Organization
Organization Name:SENIOR MOBILITY, LLC
Other - Org Name:VIP SCOOTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-574-0215
Mailing Address - Street 1:139 S CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-4326
Mailing Address - Country:US
Mailing Address - Phone:540-574-0215
Mailing Address - Fax:540-574-2494
Practice Address - Street 1:139 S CARLTON ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4326
Practice Address - Country:US
Practice Address - Phone:540-574-0215
Practice Address - Fax:540-574-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7131950001Medicare NSC