Provider Demographics
NPI:1891768735
Name:NATIONAL SEATING & MOBILITY, INC.
Entity Type:Organization
Organization Name:NATIONAL SEATING & MOBILITY, INC.
Other - Org Name:
Other - Org Type:
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 ROAD
Mailing Address - Street 2:SUITE 443
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 1:2300 VALLEY VIEW LN STE 205
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234
Practice Address - Country:US
Practice Address - Phone:972-206-7345
Practice Address - Fax:972-522-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 332BC3200X
TX0036430332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009921002Medicaid
TX009921001Medicaid
TX011277301Medicaid
OK100794550AMedicaid
TX19288301-01Medicaid
TX0570710005Medicare NSC
TX19288301-01Medicaid