Provider Demographics
NPI:1861635948
Name:GLASS SEATING AND MOBILITY
Entity Type:Organization
Organization Name:GLASS SEATING AND MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:GLASS
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:ATP
Authorized Official - Phone:901-379-0096
Mailing Address - Street 1:1687 N SHELBY OAKS DR
Mailing Address - Street 2:9
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7421
Mailing Address - Country:US
Mailing Address - Phone:901-379-0096
Mailing Address - Fax:901-379-0018
Practice Address - Street 1:9022 LANDERS RD
Practice Address - Street 2:A
Practice Address - City:N LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-1590
Practice Address - Country:US
Practice Address - Phone:501-835-0080
Practice Address - Fax:501-835-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00948332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5139690003Medicare NSC