Healthcare Provider Details

I. General information

NPI: 1104079086
Provider Name (Legal Business Name): MOBIUS SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 10/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2089 N 144TH DR
GOODYEAR AZ
85395-2334
US

IV. Provider business mailing address

2089 N 144TH DR
GOODYEAR AZ
85395-2334
US

V. Phone/Fax

Practice location:
  • Phone: 623-466-2828
  • Fax: 623-298-5022
Mailing address:
  • Phone: 623-466-2828
  • Fax: 623-298-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES MICHELS
Title or Position: MANAGER
Credential:
Phone: 623-466-2828