Provider Demographics
NPI:1518951599
Name:SOUTHERN MEDICAL & MOBILITY INC
Entity Type:Organization
Organization Name:SOUTHERN MEDICAL & MOBILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:251-633-4133
Mailing Address - Street 1:1416 W I65 SERVICE RD S
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-5100
Mailing Address - Country:US
Mailing Address - Phone:251-633-4133
Mailing Address - Fax:251-633-4575
Practice Address - Street 1:1416 W I65 SERVICE RD S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-5100
Practice Address - Country:US
Practice Address - Phone:251-633-4133
Practice Address - Fax:251-633-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL490041319332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009987760Medicaid
AL51507156OtherBLUE CROSS ALABAMA
AL950633OtherPRIME HEALTH
MS02726271Medicaid
AL1230240OtherHEALTHSPRING/SENIORS FIRS
AL1640450OtherMEDICAID OF LA.
AL=========OtherCHAMPUS/TRICARE
AL009987760Medicaid
AL950633OtherPRIME HEALTH