Healthcare Provider Details

I. General information

NPI: 1194796847
Provider Name (Legal Business Name): UNITED SEATING AND MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 DAVID DR
COLUMBIA MO
65202-2685
US

IV. Provider business mailing address

805 BROOK ST STE 402
ROCKY HILL CT
06067-3431
US

V. Phone/Fax

Practice location:
  • Phone: 573-443-2212
  • Fax:
Mailing address:
  • Phone: 314-447-7500
  • Fax: 314-447-7830

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 NumberLC0049762
License Number StateMO

VIII. Authorized Official

Name: WALTER JOHNSON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 314-447-7515