Provider Demographics
NPI:1013471531
Name:MOBILITY MEDICAL
Entity Type:Organization
Organization Name:MOBILITY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-966-0132
Mailing Address - Street 1:575 PROSPECT ST UNIT 251
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5040
Mailing Address - Country:US
Mailing Address - Phone:732-966-0132
Mailing Address - Fax:
Practice Address - Street 1:575 PROSPECT ST UNIT 251
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5040
Practice Address - Country:US
Practice Address - Phone:732-966-0132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies