Healthcare Provider Details

I. General information

NPI: 1811902406
Provider Name (Legal Business Name): MOBILE MED CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15506 COLLEGE BLVD
LENEXA KS
66219-1350
US

IV. Provider business mailing address

15506 COLLEGE BLVD
LENEXA KS
66219-1350
US

V. Phone/Fax

Practice location:
  • Phone: 913-492-1800
  • Fax: 913-438-5625
Mailing address:
  • Phone: 913-492-1800
  • Fax: 913-438-5625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number255419
License Number StateKS

VIII. Authorized Official

Name: MR. DANIEL T SIMS
Title or Position: OWNER
Credential:
Phone: 913-492-1800