Basic Information
| Provider Information | |||||||||
| NPI: | 1154635878 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL SEATING & MOBILITY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5959 SHALLOWFORD RD | ||||||||
| Address2: | SUITE 443 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374212285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237562268 | ||||||||
| FaxNumber: | 4232669690 | ||||||||
| Practice Location | |||||||||
| Address1: | 7360 EASTGATE RD STE 115 | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890114089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7025655570 | ||||||||
| FaxNumber: | 8002649032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2010 | ||||||||
| LastUpdateDate: | 03/03/2021 | ||||||||
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| AuthorizedOfficialLastName: | MATUKEWICZ | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 4237562268 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | APPLIED FOR | NV | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 1154635878 | 05 | NV | MEDICAID | 589986 | 05 | AZ | MEDICAID |