Healthcare Provider Details

I. General information

NPI: 1245269174
Provider Name (Legal Business Name): MOBILITY PLUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3107 AZALEA PARK DR
MUSKOGEE OK
74401-2284
US

IV. Provider business mailing address

PO BOX 9547
TULSA OK
74157-0547
US

V. Phone/Fax

Practice location:
  • Phone: 918-686-0218
  • Fax: 918-686-0345
Mailing address:
  • Phone: 918-686-0218
  • Fax: 918-686-0345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW A KOHLER
Title or Position: PRINCIPAL
Credential:
Phone: 918-743-4491