Provider Demographics
NPI:1841348315
Name:APPLE INDEPENDENCE MOBILITY, LLC
Entity type:Organization
Organization Name:APPLE INDEPENDENCE MOBILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:APPLE
Authorized Official - Suffix:
Authorized Official - Credentials:ATP
Authorized Official - Phone:931-528-5788
Mailing Address - Street 1:1750 LEE SEMINARY RD
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-6463
Mailing Address - Country:US
Mailing Address - Phone:931-528-5788
Mailing Address - Fax:931-432-5607
Practice Address - Street 1:1750 LEE SEMINARY RD
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-6463
Practice Address - Country:US
Practice Address - Phone:931-528-5788
Practice Address - Fax:931-432-5607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000489332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4143488OtherBLUE CROSS BLUE SHIELD
KY90008335Medicaid
TN1454365Medicaid
TN1455151Medicaid
TN3124433OtherBLUE CROSS BLUE SHIELD
TN4551640001Medicare ID - Type Unspecified
TN1454365Medicaid