Provider Demographics
NPI:1912200940
Name:JAY HATFIELD MOBILITY, LLC
Entity Type:Organization
Organization Name:JAY HATFIELD MOBILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER/MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-429-2636
Mailing Address - Street 1:200 S EAST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:KS
Mailing Address - Zip Code:66725-1955
Mailing Address - Country:US
Mailing Address - Phone:620-429-2636
Mailing Address - Fax:620-429-2997
Practice Address - Street 1:812 3RD ST
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-8459
Practice Address - Country:US
Practice Address - Phone:816-858-7925
Practice Address - Fax:916-858-7927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies