Provider Demographics
NPI:1245269174
Name:MOBILITY PLUS LLC
Entity type:Organization
Organization Name:MOBILITY PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-743-4491
Mailing Address - Street 1:PO BOX 9547
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74157-0547
Mailing Address - Country:US
Mailing Address - Phone:918-686-0218
Mailing Address - Fax:918-686-0345
Practice Address - Street 1:3107 AZALEA PARK DR
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-2284
Practice Address - Country:US
Practice Address - Phone:918-686-0218
Practice Address - Fax:918-686-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100634600CMedicaid
OK3875570001Medicare ID - Type Unspecified