MEDICARE: GRACE 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1912833773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE MOBILITY

Provider Business Mailing Address
First Line	:	115 CHERRY ST APT B
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47713-1019
Country	:	US
Telephone Number	:	812-568-0548
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 CHERRY ST APT B
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47713-1019
Country	:	US
Telephone Number	:	812-568-0548
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BRIAN MATTINGLY
Credential	:
Telephone Number	:	812-568-0548

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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Directions to “GRACE MOBILITY ” Practice Location

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