Provider Demographics
NPI:1558435651
Name:KEYSTONE MOBILITY INC
Entity Type:Organization
Organization Name:KEYSTONE MOBILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:V
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-482-8140
Mailing Address - Street 1:8118 ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8623
Mailing Address - Country:US
Mailing Address - Phone:717-482-8140
Mailing Address - Fax:717-482-8141
Practice Address - Street 1:8118 ADAMS DRIVE
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-8623
Practice Address - Country:US
Practice Address - Phone:717-482-8140
Practice Address - Fax:717-482-8141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3926670001Medicare NSC