Healthcare Provider Details

I. General information

NPI: 1669924551
Provider Name (Legal Business Name): NATIONAL SEATING & MOBILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6904 N MAIN ST STE 104
COLUMBIA SC
29203-3852
US

IV. Provider business mailing address

5959 SHALLOWFORD RD SUITE 443
CHATTANOOGA TN
37421-2285
US

V. Phone/Fax

Practice location:
  • Phone: 803-799-1133
  • Fax: 803-252-0814
Mailing address:
  • Phone: 423-756-2268
  • Fax: 423-362-5413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225CA2500X
TaxonomyAssistive Technology Supplier Rehabilitation Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY MATUKEWICZ
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 423-756-2268