Provider Demographics
NPI:1952741480
Name:A MEDI MOBILITY
Entity Type:Organization
Organization Name:A MEDI MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OKERBLOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-260-5389
Mailing Address - Street 1:625 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4505
Mailing Address - Country:US
Mailing Address - Phone:805-347-7717
Mailing Address - Fax:805-347-7734
Practice Address - Street 1:625 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-4505
Practice Address - Country:US
Practice Address - Phone:805-260-5389
Practice Address - Fax:805-347-7734
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACI MEDICAL SUPPLIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD8170348332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment