Provider Demographics
NPI:1720206089
Name:MLB MOBILITY INC
Entity Type:Organization
Organization Name:MLB MOBILITY INC
Other - Org Name:TOTALLY MOBILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MASA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEARSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-366-4338
Mailing Address - Street 1:439 RT 6A, P.O. BOX 750
Mailing Address - Street 2:
Mailing Address - City:E. SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-0750
Mailing Address - Country:US
Mailing Address - Phone:508-366-4338
Mailing Address - Fax:508-888-3392
Practice Address - Street 1:439 RT 6A
Practice Address - Street 2:
Practice Address - City:E. SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02537-0750
Practice Address - Country:US
Practice Address - Phone:508-366-4338
Practice Address - Fax:508-888-3392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4711570001Medicare NSC