Provider Demographics
NPI:1770581258
Name:BANNER MOBILITY RESOURCES INC
Entity type:Organization
Organization Name:BANNER MOBILITY RESOURCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REX
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-234-3070
Mailing Address - Street 1:231 SE 53RD ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1019
Mailing Address - Country:US
Mailing Address - Phone:785-235-3070
Mailing Address - Fax:785-862-1510
Practice Address - Street 1:231 SE 53RD ST
Practice Address - Street 2:SUITE C
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66609-1019
Practice Address - Country:US
Practice Address - Phone:785-235-3070
Practice Address - Fax:785-862-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4070650001Medicare NSC