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General NPI Number Information
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NPI Number | 1407903438
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Entity Type | Organization
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Legal Business Name | SOUTHERN MOBILITY INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13103 MORRISON RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-3738
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Country | US
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Telephone | 501-223-9348
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Fax |
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Provider Business Mailing Address
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Address Line | 13103 MORRISON RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-3738
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GREG BUMPAS
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Credential |
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Telephone | 501-223-9348
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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 | 23287760001
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License Number State | AR
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