Basic Information
| Provider Information | |||||||||
| NPI: | 1164498085 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MOBILITY CONCEPTS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 65 SHILOH RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288032929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282772577 | ||||||||
| FaxNumber: | 8282772581 | ||||||||
| Practice Location | |||||||||
| Address1: | 65 SHILOH RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288032929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282772577 | ||||||||
| FaxNumber: | 8282772581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SINGLETON | ||||||||
| AuthorizedOfficialFirstName: | TAMI | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8282772577 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | 06-00001523 | NC | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
ID Information
| ID | Type | State | Issuer | Description | 7702502 | 05 | NC | MEDICAID |