Provider Demographics
NPI:1811902406
Name:MOBILE MED CARE INC
Entity type:Organization
Organization Name:MOBILE MED CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-492-1800
Mailing Address - Street 1:15506 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1350
Mailing Address - Country:US
Mailing Address - Phone:913-492-1800
Mailing Address - Fax:913-438-5625
Practice Address - Street 1:15506 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1350
Practice Address - Country:US
Practice Address - Phone:913-492-1800
Practice Address - Fax:913-438-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS255419332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO193440OtherBLUE CROSS MISSOURI
KS701801OtherBLUE CROSS KANSAS
MO34871016OtherBLUE CROSS KANSAS CITY
IA0715409Medicaid
KS=========OtherTAX ID NUMBER
MO193440OtherBLUE CROSS MISSOURI
MO34871016OtherBLUE CROSS KANSAS CITY