Provider Demographics
NPI:1649320482
Name:ADVANCED MOBILITY SYSTEMS
Entity type:Organization
Organization Name:ADVANCED MOBILITY SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-429-1273
Mailing Address - Street 1:2110 NORTH BEACH
Mailing Address - Street 2:
Mailing Address - City:FORT WORH
Mailing Address - State:TX
Mailing Address - Zip Code:76111
Mailing Address - Country:US
Mailing Address - Phone:817-429-1273
Mailing Address - Fax:817-838-0586
Practice Address - Street 1:2110 N BEACH ST
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76111-6812
Practice Address - Country:US
Practice Address - Phone:817-429-1273
Practice Address - Fax:817-838-0586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment