Provider Demographics
NPI:1164059150
Name:ACCESS MOBILITY VANS, INC.
Entity Type:Organization
Organization Name:ACCESS MOBILITY VANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:TEVZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-758-2900
Mailing Address - Street 1:1995 E. NORSE AVE.
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110
Mailing Address - Country:US
Mailing Address - Phone:414-264-2000
Mailing Address - Fax:414-727-6945
Practice Address - Street 1:1995 E. NORSE AVE.
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110
Practice Address - Country:US
Practice Address - Phone:414-264-2000
Practice Address - Fax:414-727-6945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty