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General NPI Number Information
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NPI Number | 1265428437
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Entity Type | Organization
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Legal Business Name | ACTIVE MOBILITY & DESIGN INC
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6144 S US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34982-3951
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Country | US
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Telephone | 772-465-9600
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Fax | 772-465-0966
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Provider Business Mailing Address
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Address Line | 6144 S US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34982-3951
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Country | US
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Telephone | 772-465-9600
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Fax | 772-465-0966
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | MR. WILLIAM D BOWES
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Credential |
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Telephone | 772-465-9600
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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 | 1507
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License Number State | FL
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