Provider Demographics
NPI:1255899837
Name:MOBILELIFE LLC
Entity type:Organization
Organization Name:MOBILELIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:828-676-2760
Mailing Address - Street 1:73 AIRPORT RD STE 3
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9527
Mailing Address - Country:US
Mailing Address - Phone:828-676-2760
Mailing Address - Fax:828-676-2759
Practice Address - Street 1:73 AIRPORT RD STE 3
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9527
Practice Address - Country:US
Practice Address - Phone:828-676-2760
Practice Address - Fax:828-676-2759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02568OtherNC BOARD OF PHARMACY DME & DEVICE