Provider Demographics
NPI:1710136569
Name:A-1 MOBILITY CENTER INC
Entity Type:Organization
Organization Name:A-1 MOBILITY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSE
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:48150-6300
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:2008-09-17
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI54OH207670OtherBCBS-MICHIGAN
MI1710136569Medicaid
MI54OH207670OtherBCBS-MICHIGAN