Provider Demographics
NPI:1780610204
Name:ABILITY MOBILITY MEDICAL
Entity type:Organization
Organization Name:ABILITY MOBILITY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-631-8467
Mailing Address - Street 1:5150 INTERSTATE DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71109-6515
Mailing Address - Country:US
Mailing Address - Phone:318-631-8467
Mailing Address - Fax:318-631-6579
Practice Address - Street 1:5150 INTERSTATE DR
Practice Address - Street 2:SUITE 219
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71109-6515
Practice Address - Country:US
Practice Address - Phone:318-631-8467
Practice Address - Fax:318-631-6579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
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
LA1722154Medicaid
LA5488820001Medicare ID - Type Unspecified