Healthcare Provider Details

I. General information

NPI: 1508474396
Provider Name (Legal Business Name): NATIONAL SEATING & MOBILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S WAKE VILLAGE RD
WAKE VILLAGE TX
75501-6606
US

IV. Provider business mailing address

5959 SHALLOWFORD RD STE 443
CHATTANOOGA TN
37421-2245
US

V. Phone/Fax

Practice location:
  • Phone: 903-703-1613
  • Fax: 903-255-7768
Mailing address:
  • Phone: 423-756-2268
  • Fax: 423-362-5413

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