Healthcare Provider Details

I. General information

NPI: 1770556623
Provider Name (Legal Business Name): NATIONAL SEATING & MOBILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3361 W HOSPITAL AVE
CHAMBLEE GA
30341-3419
US

IV. Provider business mailing address

5959 SHALLOWFORD RD SUITE 443
CHATTANOOGA TN
37421-2285
US

V. Phone/Fax

Practice location:
  • Phone: 770-452-1450
  • Fax: 770-452-1398
Mailing address:
  • Phone: 423-756-2268
  • Fax: 423-266-9690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier000521595A
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer

VIII. Authorized Official

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