Provider Demographics
NPI:1235130535
Name:JAMES E. GLENEWINKEL, GLENEWINKEL SALES SERVICE, MOBILITY STORE & MORE
Entity Type:Organization
Organization Name:JAMES E. GLENEWINKEL, GLENEWINKEL SALES SERVICE, MOBILITY STORE & MORE
Other - Org Name:MOBILITY STORE & MORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:GLENEWINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-386-0446
Mailing Address - Street 1:1116 E KINGSBURY ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-4849
Mailing Address - Country:US
Mailing Address - Phone:830-386-0446
Mailing Address - Fax:830-303-2966
Practice Address - Street 1:1116 E KINGSBURY ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-2148
Practice Address - Country:US
Practice Address - Phone:830-386-0446
Practice Address - Fax:830-303-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0069926332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4849470001Medicare NSC