Provider Demographics
NPI:1164514253
Name:BLUE MOUNTAIN MOBILITY INC
Entity Type:Organization
Organization Name:BLUE MOUNTAIN MOBILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:YANNONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:610-377-5079
Mailing Address - Street 1:725 STATE ROAD
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-2851
Mailing Address - Country:US
Mailing Address - Phone:610-377-5079
Mailing Address - Fax:610-577-0283
Practice Address - Street 1:725 STATE ROAD
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-2851
Practice Address - Country:US
Practice Address - Phone:610-377-5079
Practice Address - Fax:610-577-0283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA83886462OtherSALES TAX ID NUMBER
PA=========OtherEMPLOYER IDENTIFICATION