Healthcare Provider Details

I. General information

NPI: 1558502658
Provider Name (Legal Business Name): ACCESSIBLE MOBILITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W PUTNAM AVE
GREENWICH CT
06830-5329
US

IV. Provider business mailing address

111 W PUTNAM AVE
GREENWICH CT
06830-5329
US

V. Phone/Fax

Practice location:
  • Phone: 203-869-4038
  • Fax: 203-869-3525
Mailing address:
  • Phone: 203-869-4038
  • Fax: 203-869-3525

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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRIS T CANAVAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 203-869-4038