MEDICARE: AMERICAN MEDICAL MOBILITY INC

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	:	1568535433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL MOBILITY INC

Provider Business Mailing Address
First Line	:	2493 7TH ST W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2839
Country	:	US
Telephone Number	:	651-224-3547
Fax Number	:

Provider Business Practice Location Address
First Line	:	2493 7TH ST W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2839
Country	:	US
Telephone Number	:	651-224-3547
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	CHARLES C HALLBERG
Credential	:
Telephone Number	:	651-224-3547

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	12/05/2008

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