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General NPI Number Information
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NPI Number | 1124266747
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Entity Type | Organization
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Legal Business Name | MAXIMUM MOBILITY
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 2922 FULAM CT
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City | RESCUE
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State | CA
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Zip | 95672-9474
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Country | US
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Telephone | 916-879-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 2922 FULAM CT
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City | RESCUE
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State | CA
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Zip | 95672-9474
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Country | US
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Telephone | 916-879-2677
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAMMY JUNE TROUPE
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Credential |
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Telephone | 916-879-2677
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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 | 2004-033384
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License Number State | CA
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