Healthcare Provider Details

I. General information

NPI: 1316982143
Provider Name (Legal Business Name): MOBILITY CENTRAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 12/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 OLDE TOWNE RD
VESTAVIA HILLS AL
35216-3732
US

IV. Provider business mailing address

400 OLDE TOWNE RD
VESTAVIA AL
35216-3732
US

V. Phone/Fax

Practice location:
  • Phone: 205-916-0670
  • Fax: 205-940-2299
Mailing address:
  • Phone: 205-916-0670
  • Fax: 205-940-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number05017284
License Number StateAL

VIII. Authorized Official

Name: MR. BEN MARK PETERS
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 205-916-0670