Provider Demographics
NPI:1639320146
Name:ASV MOBILITY CO
Entity Type:Organization
Organization Name:ASV MOBILITY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-368-9417
Mailing Address - Street 1:368 HEINZ CAMP RD
Mailing Address - Street 2:
Mailing Address - City:PORTERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16051-3906
Mailing Address - Country:US
Mailing Address - Phone:724-368-9417
Mailing Address - Fax:724-368-9654
Practice Address - Street 1:368 HEINZ CAMP RD
Practice Address - Street 2:
Practice Address - City:PORTERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16051-3906
Practice Address - Country:US
Practice Address - Phone:724-368-9417
Practice Address - Fax:724-368-9654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies