Provider Demographics
NPI:1396053856
Name:SUSQUEHANNA VALLEY MOBILITY SERVICES, INC.
Entity type:Organization
Organization Name:SUSQUEHANNA VALLEY MOBILITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAUVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-246-5300
Mailing Address - Street 1:302 OAK ST
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518-1619
Mailing Address - Country:US
Mailing Address - Phone:570-471-3386
Mailing Address - Fax:570-471-3376
Practice Address - Street 1:302 OAK ST
Practice Address - Street 2:
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518-1619
Practice Address - Country:US
Practice Address - Phone:570-471-3386
Practice Address - Fax:570-471-3376
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUSQUEHANNA VALLEY MOBILITY SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-18
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000007670332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019688510003Medicaid
PA0019688510003Medicaid