Provider Demographics
NPI:1699846972
Name:MICHIGAN MOBILITY CENTERS INC
Entity Type:Organization
Organization Name:MICHIGAN MOBILITY CENTERS INC
Other - Org Name:A-1 MOBILITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-422-4234
Mailing Address - Street 1:11940 MIDDLEBELT RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-6301
Mailing Address - Country:US
Mailing Address - Phone:734-422-4234
Mailing Address - Fax:734-422-5807
Practice Address - Street 1:11940 MIDDLEBELT RD
Practice Address - Street 2:SUITE H
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-6300
Practice Address - Country:US
Practice Address - Phone:734-422-4234
Practice Address - Fax:734-422-5807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4695284Medicaid
MI5400590001Medicare NSC