MEDICARE: SACRAMENTO VALLEY MOBILITY

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	:	1295121887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRAMENTO VALLEY MOBILITY

Provider Business Mailing Address
First Line	:	3612 MADISON AVE
Second Line	:	STE 31
City	:	NORTH HIGHLANDS
State	:	CA
Zip	:	95660-5068
Country	:	US
Telephone Number	:	916-877-5957
Fax Number	:

Provider Business Practice Location Address
First Line	:	3612 MADISON AVE
Second Line	:	STE 31
City	:	NORTH HIGHLANDS
State	:	CA
Zip	:	95660-5068
Country	:	US
Telephone Number	:	916-877-5957
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL T LENSER
Credential	:
Telephone Number	:	916-877-5957

Provider Enumeration Date	:	04/09/2015
Last Update Date	:	06/20/2016

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