Provider Demographics
NPI:1740386648
Name:JAY HATFIELD MOBILITY, LLC
Entity Type:Organization
Organization Name:JAY HATFIELD MOBILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-429-2636
Mailing Address - Street 1:200 S EAST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:KS
Mailing Address - Zip Code:66725-1955
Mailing Address - Country:US
Mailing Address - Phone:620-429-2636
Mailing Address - Fax:620-429-2997
Practice Address - Street 1:200 S EAST AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:KS
Practice Address - Zip Code:66725-1955
Practice Address - Country:US
Practice Address - Phone:620-429-2636
Practice Address - Fax:620-429-2997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000118392OtherBLUE CROSS BLUE SHIELD KS
KS0000118392OtherBLUE CROSS BLUE SHIELD KS