Healthcare Provider Details

I. General information

NPI: 1972080570
Provider Name (Legal Business Name): ACCESSIBLE VANS AND MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2303 WALLACE BLVD
CINNAMINSON NJ
08077-2571
US

IV. Provider business mailing address

4199 KINROSS LAKES PKWY STE 300 ATTN: COMPLIANCE
RICHFIELD OH
44286-9394
US

V. Phone/Fax

Practice location:
  • Phone: 856-829-9449
  • Fax:
Mailing address:
  • Phone: 234-200-1382
  • Fax: 330-620-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MEGAN MALOTT
Title or Position: COMPLIANCE MANAGER
Credential:
Phone: 234-200-1382