Provider Demographics
NPI:1326115023
Name:PROGRESSIVE MOBILTY CONSULTANTS LLC
Entity Type:Organization
Organization Name:PROGRESSIVE MOBILTY CONSULTANTS LLC
Other - Org Name:PROGRESSIVE MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHELE
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:PFOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-815-7600
Mailing Address - Street 1:6811 INDUSTRIAL AVE
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6824
Mailing Address - Country:US
Mailing Address - Phone:727-815-7600
Mailing Address - Fax:727-815-7660
Practice Address - Street 1:6811 INDUSTRIAL AVE
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6824
Practice Address - Country:US
Practice Address - Phone:727-815-7600
Practice Address - Fax:727-815-7660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312776332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1312776OtherHOME MEDICAL EQUIPMENT
FL031176600Medicaid
FL5567770001Medicare NSC