Provider Demographics
NPI:1811142185
Name:ULTIMATE MOBILITY LLC
Entity type:Organization
Organization Name:ULTIMATE MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-346-7655
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:PERHAM
Mailing Address - State:MN
Mailing Address - Zip Code:56573-0344
Mailing Address - Country:US
Mailing Address - Phone:218-346-7655
Mailing Address - Fax:218-346-2691
Practice Address - Street 1:301 CONEY ST W
Practice Address - Street 2:
Practice Address - City:PERHAM
Practice Address - State:MN
Practice Address - Zip Code:56573-2110
Practice Address - Country:US
Practice Address - Phone:218-346-7655
Practice Address - Fax:218-346-2691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-29
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies