Healthcare Provider Details

I. General information

NPI: 1013374792
Provider Name (Legal Business Name): JM MOBILITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 MCCLANAHAN DR SUITE A4
NORTH LITTLE ROCK AR
72116-7001
US

IV. Provider business mailing address

5301 MCCLANAHAN DR SUITE A4
NORTH LITTLE ROCK AR
72116-7001
US

V. Phone/Fax

Practice location:
  • Phone: 501-904-2719
  • Fax: 501-904-2714
Mailing address:
  • Phone: 501-904-2719
  • Fax: 501-904-2714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JACENT L WINSTON
Title or Position: CEO
Credential:
Phone: 501-904-2719