Provider Demographics
NPI:1952462293
Name:MOBILITY PLUS LLC
Entity Type:Organization
Organization Name:MOBILITY PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-384-6779
Mailing Address - Street 1:1601 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-4451
Mailing Address - Country:US
Mailing Address - Phone:918-686-0218
Mailing Address - Fax:918-684-7276
Practice Address - Street 1:200 W BLUE STARR DR STE 100
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-4228
Practice Address - Country:US
Practice Address - Phone:918-342-9955
Practice Address - Fax:918-342-9956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100634600IMedicaid
OK3875570005Medicare NSC