Provider Demographics
NPI:1023081650
Name:MOBILITY PLUS
Entity type:Organization
Organization Name:MOBILITY PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-677-3866
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0547
Mailing Address - Country:US
Mailing Address - Phone:336-677-3866
Mailing Address - Fax:336-677-3867
Practice Address - Street 1:105 WOODLYN DR
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-6673
Practice Address - Country:US
Practice Address - Phone:336-677-3866
Practice Address - Fax:336-677-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC804402OtherPARTNERS
NC7703855Medicaid
NC064A0OtherBLUE CROSS/BLUE SHEILD
NC7703855Medicaid