Provider Demographics
NPI:1215366760
Name:ACCESSIBLE MOBILITY CENTER, LLC
Entity Type:Organization
Organization Name:ACCESSIBLE MOBILITY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCESSIBLE EQUIPMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-315-1899
Mailing Address - Street 1:640 CONGAREE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3518
Mailing Address - Country:US
Mailing Address - Phone:864-315-1899
Mailing Address - Fax:864-509-6288
Practice Address - Street 1:640 CONGAREE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3518
Practice Address - Country:US
Practice Address - Phone:864-315-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies