Provider Demographics
NPI:1902841679
Name:NORTHSTAR MOBILITY & MEDICAL CO.
Entity Type:Organization
Organization Name:NORTHSTAR MOBILITY & MEDICAL CO.
Other - Org Name:NORTHSTAR MOBILITY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SPERRY
Authorized Official - Suffix:
Authorized Official - Credentials:ALB
Authorized Official - Phone:617-669-2302
Mailing Address - Street 1:11 MADISON ST
Mailing Address - Street 2:ALEX SPERRY
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-2313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 MADISON ST
Practice Address - Street 2:ALEX SPERRY
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-2313
Practice Address - Country:US
Practice Address - Phone:617-669-2302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies