Provider Demographics
NPI:1831465541
Name:TOTAL INDEPENDENCE AND MOBILITY
Entity Type:Organization
Organization Name:TOTAL INDEPENDENCE AND MOBILITY
Other - Org Name:101 MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MAHONEY
Authorized Official - Last Name:FOSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-800-8667
Mailing Address - Street 1:5720 CAPITAL BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2953
Mailing Address - Country:US
Mailing Address - Phone:919-800-8667
Mailing Address - Fax:919-882-8440
Practice Address - Street 1:5720 CAPITAL BOULEVARD SUITE E
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616
Practice Address - Country:US
Practice Address - Phone:919-800-8667
Practice Address - Fax:919-882-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies