Provider Demographics
NPI:1255424990
Name:GULF COAST MOBILITY,INC.
Entity type:Organization
Organization Name:GULF COAST MOBILITY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUTHR
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-591-8990
Mailing Address - Street 1:1750 J & C BLVD
Mailing Address - Street 2:STE.#10
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109
Mailing Address - Country:US
Mailing Address - Phone:239-591-8990
Mailing Address - Fax:239-591-4980
Practice Address - Street 1:1750 J & C BLVD
Practice Address - Street 2:STE.#10
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109
Practice Address - Country:US
Practice Address - Phone:239-591-8990
Practice Address - Fax:239-591-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL922490332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1255424990OtherNPI
FL1255424990OtherNPI