Provider Demographics
NPI:1568567873
Name:ELECTRIC MOBILITY CORPORATION
Entity Type:Organization
Organization Name:ELECTRIC MOBILITY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ERACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-539-3019
Mailing Address - Street 1:2600 N 44TH ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-1521
Mailing Address - Country:US
Mailing Address - Phone:602-955-7722
Mailing Address - Fax:602-955-7050
Practice Address - Street 1:591 MANTUA BLVD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1016
Practice Address - Country:US
Practice Address - Phone:856-539-3019
Practice Address - Fax:856-539-3061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5001899332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0455640003Medicare ID - Type UnspecifiedMEDICARE PROVIDER #