Basic Information
Provider Information
NPI: 1962433045
EntityType: 2
ReplacementNPI:  
OrganizationName: GOBILITY MOBILITY LLC
LastName:  
FirstName:  
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Credential:  
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Mailing Information
Address1: PO BOX 708126
Address2:  
City: SANDY
State: UT
PostalCode: 840708126
CountryCode: US
TelephoneNumber: 8014653609
FaxNumber: 8014659998
Practice Location
Address1: 2975 EXECUTIVE PKWY STE 159
Address2:  
City: LEHI
State: UT
PostalCode: 840439019
CountryCode: US
TelephoneNumber: 8014653609
FaxNumber: 8014659998
Other Information
ProviderEnumerationDate: 07/06/2006
LastUpdateDate: 03/25/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CHARLES
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 8018367630
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000XJ09905UTY SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


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