Provider Demographics
NPI:1275311359
Name:CLARKSON MOBILITY 24/7/365 LLC.
Entity Type:Organization
Organization Name:CLARKSON MOBILITY 24/7/365 LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:SHAUN EMORY
Authorized Official - Last Name:CLARKSON
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:574-387-9160
Mailing Address - Street 1:5316 REO AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46619-1341
Mailing Address - Country:US
Mailing Address - Phone:574-343-9969
Mailing Address - Fax:
Practice Address - Street 1:5316 REO AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46619-1341
Practice Address - Country:US
Practice Address - Phone:574-343-9969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)