Provider Demographics
NPI:1710403209
Name:SHORE MOBILITY INC.
Entity Type:Organization
Organization Name:SHORE MOBILITY INC.
Other - Org Name:101 MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-453-5737
Mailing Address - Street 1:58 LOG CANOE CIR
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-2136
Mailing Address - Country:US
Mailing Address - Phone:443-453-5737
Mailing Address - Fax:
Practice Address - Street 1:58 LOG CANOE CIR
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2136
Practice Address - Country:US
Practice Address - Phone:443-453-5737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies