Provider Demographics
NPI:1831938547
Name:ADAPTIVE STAR MOBILITY INC.
Entity type:Organization
Organization Name:ADAPTIVE STAR MOBILITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:M
Authorized Official - Last Name:DURRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-278-9626
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-0369
Mailing Address - Country:US
Mailing Address - Phone:800-278-9626
Mailing Address - Fax:
Practice Address - Street 1:732 N 16TH AVE STE 26
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1890
Practice Address - Country:US
Practice Address - Phone:800-278-9626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment