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General NPI Number Information
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NPI Number | 1780680108
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Entity Type | Organization
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Legal Business Name | MOBILITY SUPPORT SYSTEMS INC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 560 PINE ISLAND RD STE 2
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City | N FT MYERS
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State | FL
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Zip | 33903
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Country | US
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Telephone | 239-997-3000
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Fax | 239-997-1276
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Provider Business Mailing Address
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Address Line | 560 PINE ISLAND RD STE 2
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City | N FT MYERS
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State | FL
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Zip | 33903-3701
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Country | US
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Telephone | 239-997-3000
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Fax | 239-997-1276
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Authorized Official
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Title or Position | CEO
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Name | MR. ANTHONY B KOEPP
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Credential |
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Telephone | 239-997-3000
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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 | 1441
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License Number State | FL
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