Provider Demographics
NPI:1326009457
Name:MOBILE VISIONS INC
Entity Type:Organization
Organization Name:MOBILE VISIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:C
Authorized Official - Last Name:FORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-245-0647
Mailing Address - Street 1:7820 N POINT BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3299
Mailing Address - Country:US
Mailing Address - Phone:336-245-0647
Mailing Address - Fax:336-245-0649
Practice Address - Street 1:3330 HEALY DR STE 100
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2024
Practice Address - Country:US
Practice Address - Phone:336-245-0647
Practice Address - Fax:336-245-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8105027Medicaid
NC8105027Medicaid