Provider Demographics
NPI:1205909231
Name:UNIVERSAL MOBILITY EQUIPMENT , LLC
Entity type:Organization
Organization Name:UNIVERSAL MOBILITY EQUIPMENT , LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-262-0041
Mailing Address - Street 1:5225 S VALLEY VIEW BLVD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1602
Mailing Address - Country:US
Mailing Address - Phone:702-262-0041
Mailing Address - Fax:702-262-0045
Practice Address - Street 1:5225 S VALLEY VIEW BLVD
Practice Address - Street 2:SUITE 10
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1602
Practice Address - Country:US
Practice Address - Phone:702-262-0041
Practice Address - Fax:702-262-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
5815090001Medicare NSC