Provider Demographics
NPI:1932241817
Name:ROCKY MOUNTAIN MOBILITY SALES AND SERVICE
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN MOBILITY SALES AND SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:JEROLD
Authorized Official - Last Name:BELZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:307-266-3557
Mailing Address - Street 1:562 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-3337
Mailing Address - Country:US
Mailing Address - Phone:307-266-3557
Mailing Address - Fax:307-266-3557
Practice Address - Street 1:562 S PARK ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3337
Practice Address - Country:US
Practice Address - Phone:307-266-3557
Practice Address - Fax:307-266-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY01-0-08350A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY5303300001Medicare NSC