Healthcare Provider Details

I. General information

NPI: 1548975147
Provider Name (Legal Business Name): AZ MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 E LONE CACTUS DR
PHOENIX AZ
85024-5651
US

IV. Provider business mailing address

4199 KINROSS LAKES PARKWAY - ATTN COMPLIANCE 300
RICHFIELD OH
44286
US

V. Phone/Fax

Practice location:
  • Phone: 866-719-1666
  • Fax:
Mailing address:
  • Phone: 234-200-1379
  • Fax:

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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: PAUL BRITTON
Title or Position: VP & SECRETARY
Credential:
Phone: 234-200-1426