Basic Information
| Provider Information | |||||||||
| NPI: | 1982677530 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL SEATING & MOBILITY, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5959 SHALLOWFORD RD | ||||||||
| Address2: | SUITE 443 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374212285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237562268 | ||||||||
| FaxNumber: | 4232669690 | ||||||||
| Practice Location | |||||||||
| Address1: | 3535 INDUSTRIAL DR STE B1 | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075442412 | ||||||||
| FaxNumber: | 7075445128 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 08/06/2018 | ||||||||
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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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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 102556 | CA | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | DME02938F | 05 | CA | MEDICAID |