Basic Information
| Provider Information | |||||||||
| NPI: | 1235102179 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL SEATING & MOBILITY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5959 SHALLOWFORD RD | ||||||||
| Address2: | STE 443 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372412245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237562268 | ||||||||
| FaxNumber: | 4232669690 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 S SINCLAIR ST | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928065927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149399322 | ||||||||
| FaxNumber: | 7149399323 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 04/27/2021 | ||||||||
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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: | 04/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 100927 | CA | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 1235102179 | 05 | CA | MEDICAID |