Provider Demographics
NPI:1912022633
Name:A1 MOBILITY PRODUCTS
Entity Type:Organization
Organization Name:A1 MOBILITY PRODUCTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASSARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-654-2221
Mailing Address - Street 1:180 WILKES PLAZA
Mailing Address - Street 2:ROUTE 309
Mailing Address - City:WILKES BARRE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-270-5336
Mailing Address - Fax:570-270-5889
Practice Address - Street 1:180 WILKES PLAZA
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-270-5336
Practice Address - Fax:570-270-5889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101658664 0001Medicaid
PA8664199458Medicare ID - Type Unspecified