Provider Demographics
NPI:1265860647
Name:MOBILITY TRANSPORT LLC
Entity Type:Organization
Organization Name:MOBILITY TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CDONA, LNHA
Authorized Official - Phone:269-964-8452
Mailing Address - Street 1:235 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3003
Mailing Address - Country:US
Mailing Address - Phone:269-964-8452
Mailing Address - Fax:269-964-3101
Practice Address - Street 1:131 COLUMBIA AVE E
Practice Address - Street 2:SUITE 208
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3788
Practice Address - Country:US
Practice Address - Phone:269-964-8452
Practice Address - Fax:269-964-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE0049N343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)