Provider Demographics
NPI:1013901941
Name:MARQUIS MOBILITY, INC.
Entity Type:Organization
Organization Name:MARQUIS MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:WORSTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-497-5373
Mailing Address - Street 1:4051 WHIPPLE AVE NW
Mailing Address - Street 2:STE E
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2977
Mailing Address - Country:US
Mailing Address - Phone:330-497-5373
Mailing Address - Fax:
Practice Address - Street 1:4051 WHIPPLE AVE NW
Practice Address - Street 2:STE E
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2977
Practice Address - Country:US
Practice Address - Phone:330-497-5373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2142167Medicaid
OH0881780001Medicare ID - Type Unspecified