Provider Demographics
NPI:1619733748
Name:MOBILECARE SOUTH
Entity Type:Organization
Organization Name:MOBILECARE SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-444-8674
Mailing Address - Street 1:2501 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-2149
Mailing Address - Country:US
Mailing Address - Phone:214-444-8674
Mailing Address - Fax:
Practice Address - Street 1:2501 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-2149
Practice Address - Country:US
Practice Address - Phone:214-444-8674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WADLEY GUILD FOR CANCER AND LEUKEMIA RESEARCH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy