Provider Demographics
NPI:1154508778
Name:MOBILIFE, LLC
Entity Type:Organization
Organization Name:MOBILIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUFRESNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-646-5433
Mailing Address - Street 1:78 ENTERPRISE RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1763
Mailing Address - Country:US
Mailing Address - Phone:262-646-5433
Mailing Address - Fax:262-646-5463
Practice Address - Street 1:78 ENTERPRISE RD UNIT D
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1763
Practice Address - Country:US
Practice Address - Phone:262-646-5433
Practice Address - Fax:262-646-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies