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General NPI Number Information
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NPI Number | 1205804531
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Entity Type | Organization
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Legal Business Name | MOBILITY EXPRESS OF GEORGIA, INC.
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Dates
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Enumeration Date | 03/11/2006
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 1580 HOLCOMB BRIDGE RD SUITE 3
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City | ROSWELL
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State | GA
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Zip | 30076-2289
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Country | US
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Telephone | 770-998-9984
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Fax |
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Provider Business Mailing Address
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Address Line | 1580 HOLCOMB BRIDGE RD SUITE 3
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City | ROSWELL
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State | GA
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Zip | 30076-2289
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Country | US
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Telephone | 770-998-9984
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER FUJIMOTO
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Credential |
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Telephone | 770-998-9984
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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 | 301755413
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License Number State | GA
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