Provider Demographics
NPI:1851996391
Name:MOBILE FIRST LLC
Entity Type:Organization
Organization Name:MOBILE FIRST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKOFSKI
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:628-226-5769
Mailing Address - Street 1:21 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-2922
Mailing Address - Country:US
Mailing Address - Phone:628-226-5769
Mailing Address - Fax:
Practice Address - Street 1:21 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-2922
Practice Address - Country:US
Practice Address - Phone:628-226-5769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service