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General NPI Number Information
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NPI Number | 1326431404
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Entity Type | Organization
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Legal Business Name | PEDIATRIC MOBILITY INNOVATIONS
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 4458 AUGUSTA ROAD SUITE 1B
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City | LEXINGTON
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State | SC
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Zip | 29073
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Country | US
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Telephone | 803-399-1142
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Fax | 803-399-1946
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Provider Business Mailing Address
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Address Line | 4458 AUGUSTA ROAD SUITE 1B
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City | LEXINGTON
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State | SC
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Zip | 29073
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Country | US
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Telephone | 803-399-1142
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Fax | 803-399-1946
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Authorized Official
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Title or Position | PRESIDENT
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Name | SETH DOWNIE
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Credential |
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Telephone | 803-399-1142
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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 |
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License Number State |
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