Provider Demographics
NPI:1497420145
Name:MOBILITY REPAIR COMPANY OF BEDFORD
Entity Type:Organization
Organization Name:MOBILITY REPAIR COMPANY OF BEDFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUCNER
Authorized Official - Middle Name:JR
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-277-4484
Mailing Address - Street 1:2301 TAYLOR POND LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-4406
Mailing Address - Country:US
Mailing Address - Phone:617-910-0075
Mailing Address - Fax:
Practice Address - Street 1:2301 TAYLOR POND LN
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-4406
Practice Address - Country:US
Practice Address - Phone:617-910-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-14
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty