MEDICARE: UNIVERSAL MOBILITY EQUIPMENT , LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1205909231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL MOBILITY EQUIPMENT , LLC

Provider Business Mailing Address
First Line	:	5225 S VALLEY VIEW BLVD
Second Line	:	SUITE 10
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1602
Country	:	US
Telephone Number	:	702-262-0041
Fax Number	:	702-262-0045

Provider Business Practice Location Address
First Line	:	5225 S VALLEY VIEW BLVD
Second Line	:	SUITE 10
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1602
Country	:	US
Telephone Number	:	702-262-0041
Fax Number	:	702-262-0045

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. THOMAS FLYNN
Credential	:
Telephone Number	:	702-262-0041

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	06/26/2008

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