Provider Demographics
NPI:1578505376
Name:CENTRAL MOBILITY & REHAB EQUIPMENT INC.
Entity Type:Organization
Organization Name:CENTRAL MOBILITY & REHAB EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:DORCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-566-1674
Mailing Address - Street 1:PO BOX 550309
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-0309
Mailing Address - Country:US
Mailing Address - Phone:205-566-1674
Mailing Address - Fax:205-278-6900
Practice Address - Street 1:11433 US HIGHWAY 441
Practice Address - Street 2:SUITE 2
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4632
Practice Address - Country:US
Practice Address - Phone:352-742-7878
Practice Address - Fax:352-742-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2351332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026870400Medicaid