Provider Demographics
NPI:1548386253
Name:VETMOBILE SERVICES INC.
Entity Type:Organization
Organization Name:VETMOBILE SERVICES INC.
Other - Org Name:MEDAIDE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIMNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-717-5603
Mailing Address - Street 1:26911 TWENTY MULE TEAM RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BORON
Mailing Address - State:CA
Mailing Address - Zip Code:93516-1569
Mailing Address - Country:US
Mailing Address - Phone:310-717-5603
Mailing Address - Fax:760-373-8360
Practice Address - Street 1:26911 TWENTY MULE TEAM RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BORON
Practice Address - State:CA
Practice Address - Zip Code:93516-1569
Practice Address - Country:US
Practice Address - Phone:310-717-5603
Practice Address - Fax:760-373-8360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1316530001Medicare NSC