Provider Demographics
NPI:1891711032
Name:SOUTHWEST MOBILITY INCORPORATED
Entity Type:Organization
Organization Name:SOUTHWEST MOBILITY INCORPORATED
Other - Org Name:SCOOTER MOBILITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-426-2970
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32170-0042
Mailing Address - Country:US
Mailing Address - Phone:386-426-2970
Mailing Address - Fax:386-426-6292
Practice Address - Street 1:2500 STARLING ST
Practice Address - Street 2:SUITE 105
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4219
Practice Address - Country:US
Practice Address - Phone:912-342-1004
Practice Address - Fax:912-342-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA825649194AMedicaid
GA52069832OtherGA BCBS
GA3972960004Medicare NSC