Provider Demographics
NPI:1568493575
Name:DESERT HEALTH MOBILITY PLUS
Entity Type:Organization
Organization Name:DESERT HEALTH MOBILITY PLUS
Other - Org Name:MOBILITY PLUS OF FYUMA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:PADRNOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA RRT
Authorized Official - Phone:928-329-7235
Mailing Address - Street 1:1700 S 1ST AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-5745
Mailing Address - Country:US
Mailing Address - Phone:928-329-7235
Mailing Address - Fax:928-329-7242
Practice Address - Street 1:1700 S 1ST AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-5745
Practice Address - Country:US
Practice Address - Phone:928-329-7235
Practice Address - Fax:928-329-7242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1042200001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER