Healthcare Provider Details
I. General information
NPI: 1972573137
Provider Name (Legal Business Name): UNITED SEATING AND MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2006
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4260 BUCKINGHAM DR SUITE 120
COLORADO SPRINGS CO
80907-9700
US
IV. Provider business mailing address
805 BROOK ST STE 402
ROCKY HILL CT
06067-3431
US
V. Phone/Fax
- Phone: 719-520-5577
- Fax: 719-520-0033
- Phone: 314-447-7500
- Fax: 314-447-7830
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 20011195317 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WALTER
JOHNSON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 314-447-7515