Provider Demographics
NPI:1730105958
Name:SOUTHWEST MOBILITY INCORPORATED
Entity Type:Organization
Organization Name:SOUTHWEST MOBILITY INCORPORATED
Other - Org Name:SCOOTER MOBILITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-426-2970
Mailing Address - Street 1:1972 STATE ROAD 44
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-8349
Mailing Address - Country:US
Mailing Address - Phone:386-426-5069
Mailing Address - Fax:386-426-6292
Practice Address - Street 1:335 SEMORAN BLVD
Practice Address - Street 2:SUITE 127
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730-2782
Practice Address - Country:US
Practice Address - Phone:407-975-0800
Practice Address - Fax:407-975-0833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022312300Medicaid
FL3972960002Medicare NSC
GA3972960003Medicare NSC
FL022312300Medicaid