Provider Demographics
NPI:1225473747
Name:MOBILE MEDICAL TECHNOLOGIES INC
Entity Type:Organization
Organization Name:MOBILE MEDICAL TECHNOLOGIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:PANNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-366-7301
Mailing Address - Street 1:3450 BABCOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2410
Mailing Address - Country:US
Mailing Address - Phone:412-366-7301
Mailing Address - Fax:
Practice Address - Street 1:3450 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2410
Practice Address - Country:US
Practice Address - Phone:412-366-7301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07098320Medicaid
PAM583249Medicare UPIN