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General NPI Number Information
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NPI Number | 1720949688
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Entity Type | Organization
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Legal Business Name | MOBILEMED PAS DIVISION
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 4000 ELLENBORO LN
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City | FORT WORTH
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State | TX
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Zip | 76244-4368
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Country | US
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Telephone | 866-616-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 5830 E 2ND ST, STE 7000 #17696
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City | CASPER
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State | WY
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Zip | 82609-4308
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Country | US
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Telephone | 866-616-6333
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Fax |
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Authorized Official
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Title or Position | OWNER / CEO
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Name | CAROLYN JOHNSON
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Credential |
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Telephone | 866-616-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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