Healthcare Provider Details

I. General information

NPI: 1356390702
Provider Name (Legal Business Name): MOBILITY MEDICAL OF NORTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2565 HALLS MILL RD UNIT F
MOBILE AL
36606
US

IV. Provider business mailing address

554 PARK LN STE B
FLOWOOD MS
39232-8895
US

V. Phone/Fax

Practice location:
  • Phone: 601-932-1001
  • Fax: 601-932-2130
Mailing address:
  • Phone: 601-932-1001
  • Fax: 601-932-2130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number25882
License Number StateMS

VIII. Authorized Official

Name: MRS. DANYELLE CARROLL
Title or Position: CEO/OWNER
Credential:
Phone: 601-932-1001