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NPI Code Detail

MEDICARE: INDEPENDENT MOBILITY, LLC.

MEDICARE: INDEPENDENT MOBILITY, 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
1332B00000XDurable Medical Equipment & Medical Supplies1617680OH

General Provider Information

NPI Number : 1427091818
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDEPENDENT MOBILITY, LLC.
Provider Business Mailing Address
First Line : 520 YOUNGSTOWN POLAND RD
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-1103
Country : US
Telephone Number : 330-750-0440
Fax Number : 330-750-0444
Provider Business Practice Location Address
First Line : 520 YOUNGSTOWN POLAND RD
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-1103
Country : US
Telephone Number : 330-750-0440
Fax Number : 330-750-0444
Authorized Official
Title or Position : PRESIDENT/CEO/OWNER
Name : MR. BRIAN EDWARD FANNON
Credential :
Telephone Number : 330-750-0440
Provider Enumeration Date : 06/14/2006
Last Update Date : 04/24/2008

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Directions to “INDEPENDENT MOBILITY, LLC. ” Practice Location

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