Healthcare Provider Details

I. General information

NPI: 1932024437
Provider Name (Legal Business Name): SOUTHERN MOBILITY SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5348 HIGHWAY 45 S
SELMER TN
38375-6685
US

IV. Provider business mailing address

5348 HIGHWAY 45 S
SELMER TN
38375-6685
US

V. Phone/Fax

Practice location:
  • Phone: 731-439-8114
  • Fax: 731-439-8124
Mailing address:
  • Phone: 731-439-8114
  • Fax: 731-439-8124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. REGINA LYNN GRIMES
Title or Position: VICE PRESIDENT
Credential: PT, C/NDT, ATP, CRTS
Phone: 662-260-4870