Provider Demographics
NPI:1851397228
Name:SCOOTER FACTORY OUTLET INC
Entity Type:Organization
Organization Name:SCOOTER FACTORY OUTLET INC
Other - Org Name:SCOOTERS PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-337-1773
Mailing Address - Street 1:PO BOX 61003
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33906-1003
Mailing Address - Country:US
Mailing Address - Phone:239-337-1773
Mailing Address - Fax:239-337-0585
Practice Address - Street 1:3083 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7002
Practice Address - Country:US
Practice Address - Phone:239-337-1773
Practice Address - Fax:239-337-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1033770001Medicare NSC