MEDICARE: ACTION MOBILITY & MEDICAL SUPPLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1013012392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTION MOBILITY & MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	140 N SAN JACINTO ST
Second Line	:
City	:	HEMET
State	:	CA
Zip	:	92543-4450
Country	:	US
Telephone Number	:	951-929-1055
Fax Number	:	951-929-6044

Provider Business Practice Location Address
First Line	:	140 N SAN JACINTO ST
Second Line	:
City	:	HEMET
State	:	CA
Zip	:	92543-4450
Country	:	US
Telephone Number	:	951-929-1055
Fax Number	:	951-929-6044

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TOURYALAI SHALIKAR
Credential	:
Telephone Number	:	951-929-1055

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	12/13/2007

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