Provider Demographics
NPI:1386043990
Name:THE HUPP MOBILE, INC
Entity Type:Organization
Organization Name:THE HUPP MOBILE, INC
Other - Org Name:THE HUPP MOBILE, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HUPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-495-6369
Mailing Address - Street 1:2875 ROANOKE ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2747
Mailing Address - Country:US
Mailing Address - Phone:330-495-6369
Mailing Address - Fax:330-481-4665
Practice Address - Street 1:2875 ROANOKE ST NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2747
Practice Address - Country:US
Practice Address - Phone:330-495-6369
Practice Address - Fax:330-481-4665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH765435343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0106162Medicaid