Provider Demographics
NPI:1457654311
Name:MOBILEXPRESS LLC
Entity Type:Organization
Organization Name:MOBILEXPRESS LLC
Other - Org Name:MOBILEXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-681-2318
Mailing Address - Street 1:1215 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-2706
Mailing Address - Country:US
Mailing Address - Phone:559-681-2318
Mailing Address - Fax:559-323-1271
Practice Address - Street 1:1215 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-2706
Practice Address - Country:US
Practice Address - Phone:559-681-2318
Practice Address - Fax:559-323-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6603420001Medicare NSC