Healthcare Provider Details

I. General information

NPI: 1720206089
Provider Name (Legal Business Name): MLB MOBILITY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 RT 6A
E. SANDWICH MA
02537-0750
US

IV. Provider business mailing address

439 RT 6A, P.O. BOX 750
E. SANDWICH MA
02537-0750
US

V. Phone/Fax

Practice location:
  • Phone: 508-366-4338
  • Fax: 508-888-3392
Mailing address:
  • Phone: 508-366-4338
  • Fax: 508-888-3392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMA

VIII. Authorized Official

Name: MS. MASA L BEARSE
Title or Position: OWNER
Credential:
Phone: 508-366-4338