Provider Demographics
NPI:1225470107
Name:MOBILE MEDICAL UNIT
Entity Type:Organization
Organization Name:MOBILE MEDICAL UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS AND ANALYTIC
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-452-5241
Mailing Address - Street 1:1910 SASSAFRAS ST
Mailing Address - Street 2:100
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2716
Mailing Address - Country:US
Mailing Address - Phone:814-452-7266
Mailing Address - Fax:
Practice Address - Street 1:2314 SASSAFRAS ST
Practice Address - Street 2:200
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2722
Practice Address - Country:US
Practice Address - Phone:814-452-7266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty