Provider Demographics
NPI:1396820429
Name:LOW COUNTRY MOBILITY, INC
Entity Type:Organization
Organization Name:LOW COUNTRY MOBILITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOBEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-351-0901
Mailing Address - Street 1:PO BOX 30097
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-0097
Mailing Address - Country:US
Mailing Address - Phone:912-351-0901
Mailing Address - Fax:
Practice Address - Street 1:2020 DELESSEPS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-4752
Practice Address - Country:US
Practice Address - Phone:912-351-0901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20018685869332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000708529AMedicaid
SCDE1475Medicaid
SCDE1475Medicaid