Healthcare Provider Details
I. General information
NPI: 1144209792
Provider Name (Legal Business Name): AMERICAN MOBILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2006
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2921 VETERANS HWY UNIT C
BRISTOL PA
19007-1605
US
IV. Provider business mailing address
2921 VETERANS HWY UNIT C
BRISTOL PA
19007-1605
US
V. Phone/Fax
- Phone: 215-788-1919
- Fax: 215-788-3499
- Phone: 215-788-1919
- Fax: 215-788-3499
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 7562209 |
| Identifier Type | MEDICAID |
| Identifier State | NJ |
| Identifier Issuer | |
| # 2 | |
| Identifier | 297294 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | HIGHMARK BLUE CROSS/SHIEL |
| # 3 | |
| Identifier | 32359 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | AETNA |
| # 4 | |
| Identifier | 0002966000 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | PERSONAL CHOICE |
| # 5 | |
| Identifier | 0016949800004 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
ANTHONY
GERVASIO
Title or Position: PRESIDENT
Credential:
Phone: 215-788-1919