Basic Information
| Provider Information | |||||||||
| NPI: | 1912987132 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNITED SEATING AND MOBILITY LLC | ||||||||
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| OtherOrganizationName: | NUMOTION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2070 LITTLE HILLS EXPY | ||||||||
| Address2: | |||||||||
| City: | SAINT CHARLES | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633013708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144477500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13300 LAKEFRONT DR | ||||||||
| Address2: | |||||||||
| City: | EARTH CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630451513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146999500 | ||||||||
| FaxNumber: | 3142910766 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | WALTER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3144477515 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | 332B00000X | LC0049762 | MO | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 34833 | 01 | MO | HEALTHCARE USA | OTHER | 251910864 | 01 | MO | GREAT WEST LIFE & ANNUITY | OTHER | 141330100 | 01 | MO | US DEPT OF LABOR | OTHER | 276581 | 01 | MO | AETNA NATIONAL HMO | OTHER | 620423707 | 01 | MO | MISSOURI CARE | OTHER | 149833 | 01 | MO | BCBS OF MO | OTHER | 109967 | 01 | MO | GROUP HEALTH PLAN | OTHER | 1912987132 | 05 | IA | MEDICAID | 7100222980 | 05 | KY | MEDICAID | 407089 | 01 | MO | HUMANA CHOICE CARE | OTHER | 620423707 | 05 | MO | MEDICAID | 7282299 | 01 | MO | AETNA NATIONAL NON-HMO | OTHER | 464794 | 01 | MO | HEALTHLINK | OTHER |