Healthcare Provider Details
I. General information
NPI: 1942937263
Provider Name (Legal Business Name): US MOBILE CARE MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2022
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 WALL ST FL 20
NEW YORK NY
10005-2123
US
IV. Provider business mailing address
14 WALL ST FL 20
NEW YORK NY
10005-2123
US
V. Phone/Fax
- Phone: 347-298-4100
- Fax: 347-227-1368
- Phone: 347-298-4100
- Fax: 347-227-1368
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
JONA
J
TAJONERA
Title or Position: CEO
Credential:
Phone: 347-298-4100