Provider Demographics
NPI:1891707030
Name:SCOOTERS AMERICA LLC
Entity Type:Organization
Organization Name:SCOOTERS AMERICA LLC
Other - Org Name:AMERICAN SEATING & MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATUKEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-756-2268
Mailing Address - Street 1:5959 SHALLOWFORD RD STE 443
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2245
Mailing Address - Country:US
Mailing Address - Phone:423-756-2268
Mailing Address - Fax:423-266-9690
Practice Address - Street 1:7525 NE AMBASSADOR PL STE B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-6808
Practice Address - Country:US
Practice Address - Phone:503-253-4655
Practice Address - Fax:032-534-6405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOOTERS AMERICA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-13
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202382OtherBCBS
KS200414480AMedicaid
AR159247716Medicaid
KY90013053Medicaid
PA1016432310001Medicaid
OKOHCA200223Medicaid
IA0722710Medicaid
OR181416Medicaid
MO626221808Medicaid
MO626221808Medicaid
KS200414480AMedicaid