Provider Demographics
NPI:1710983838
Name:FRONTIER ACCESS & MOBILITY SYSTEMS, INC
Entity Type:Organization
Organization Name:FRONTIER ACCESS & MOBILITY SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON-MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:ATS, CRTS
Authorized Official - Phone:307-637-7663
Mailing Address - Street 1:1207 E PERSHING BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3229
Mailing Address - Country:US
Mailing Address - Phone:307-637-7663
Mailing Address - Fax:307-637-7745
Practice Address - Street 1:1207 E PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3229
Practice Address - Country:US
Practice Address - Phone:307-637-7663
Practice Address - Fax:307-637-7745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY02-0-05230332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1089550001Medicare ID - Type UnspecifiedPROVIDER NUMBER