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General NPI Number Information
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NPI Number | 1255364212
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Entity Type | Organization
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Legal Business Name | EXTREME MOBILITY INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 2551 REGENCY RD SUITE 105
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City | LEXINGTON
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State | KY
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Zip | 40503-2963
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Country | US
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Telephone | 859-277-0105
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Fax | 859-277-0135
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Provider Business Mailing Address
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Address Line | 2551 REGENCY RD SUITE 105
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City | LEXINGTON
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State | KY
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Zip | 40503-3143
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Country | US
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Telephone | 859-277-0105
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Fax | 859-277-0135
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID FLOYD ADAIR
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Credential |
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Telephone | 859-277-0105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 277833
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License Number State | KY
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