Basic Information
Provider Information
NPI: 1811521289
EntityType: 2
ReplacementNPI:  
OrganizationName: UNITED SEATING AND MOBILITY LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NUMOTION
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2070 LITTLE HILLS EXPY
Address2:  
City: SAINT CHARLES
State: MO
PostalCode: 633013708
CountryCode: US
TelephoneNumber: 3144477500
FaxNumber:  
Practice Location
Address1: 388 OLD NISKAYUNA RD
Address2:  
City: LATHAM
State: NY
PostalCode: 121102200
CountryCode: US
TelephoneNumber: 5183853920
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/25/2020
LastUpdateDate: 02/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JOHNSON
AuthorizedOfficialFirstName: WALTER
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MGR OF LICENSURE AND CREDENTIALING
AuthorizedOfficialTelephone: 3144477515
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332BC3200X  Y SuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment

No ID Information.


Home