Healthcare Provider Details

I. General information

NPI: 1477197879
Provider Name (Legal Business Name): NATIONAL SEATING & MOBILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 FORD ST. EXTENTION UNIT 101
FORT MYERS FL
33916-9318
US

IV. Provider business mailing address

5959 SHALLOWFORD RD STE 443
CHATTANOOGA TN
37421-2245
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-7070
  • Fax: 239-936-7367
Mailing address:
  • Phone: 423-756-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY MATUKEWICZ
Title or Position: SECRETARY
Credential:
Phone: 423-756-2268