Healthcare Provider Details

I. General information

NPI: 1578897559
Provider Name (Legal Business Name): MOBILITY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4280 PLAINFILED AVE NE
GRAND RAPIDS MI
49525-1194
US

IV. Provider business mailing address

4280 PLAINFILED AVE NE
GRAND RAPIDS MI
49525-1194
US

V. Phone/Fax

Practice location:
  • Phone: 616-367-1559
  • Fax: 616-361-7559
Mailing address:
  • Phone: 616-367-1559
  • Fax: 616-361-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JASON HURD
Title or Position: STORE MANAGER
Credential:
Phone: 989-777-2060