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General NPI Number Information
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NPI Number | 1093184293
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Entity Type | Organization
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Legal Business Name | MOBILITY ACCESS,LLC
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 485 NEW PARK AVE STE F3
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City | WEST HARTFORD
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State | CT
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Zip | 06110-1333
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Country | US
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Telephone | 860-904-6653
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Fax | 860-216-4197
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Provider Business Mailing Address
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Address Line | 485 NEW PARK AVE STE F3
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City | WEST HARTFORD
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State | CT
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Zip | 06110-1333
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Country | US
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Telephone | 860-904-6653
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Fax | 860-216-4197
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JOHN THOMAS MACDONALD JR.
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Credential |
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Telephone | 860-904-6653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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