Provider Demographics
NPI:1942937263
Name:US MOBILE CARE MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:US MOBILE CARE MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JONA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAJONERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-298-4100
Mailing Address - Street 1:14 WALL ST FL 20
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-2123
Mailing Address - Country:US
Mailing Address - Phone:347-298-4100
Mailing Address - Fax:347-227-1368
Practice Address - Street 1:14 WALL ST FL 20
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-2123
Practice Address - Country:US
Practice Address - Phone:347-298-4100
Practice Address - Fax:347-227-1368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
8233030001OtherNOVITAS