Healthcare Provider Details

I. General information

NPI: 1053753988
Provider Name (Legal Business Name): UNITED SEATING AND MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWTHORNE AVE SE C340
SALEM OR
97301-5860
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 503-385-4954
  • Fax: 503-391-7325
Mailing address:
  • Phone: 314-447-7500
  • Fax: 314-447-7830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SONIA LEE VILLESCAS
Title or Position: SR MGR LICENSING & CREDENTIALING
Credential:
Phone: 314-447-7515