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General NPI Number Information
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NPI Number | 1801030663
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Entity Type | Organization
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Legal Business Name | APPLE INDEPENDENCE MOBILITY LLC
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 1152 PINE ST
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City | LEBANON
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State | TN
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Zip | 37087-3769
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Country | US
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Telephone | 931-528-5788
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Fax | 931-528-5789
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Provider Business Mailing Address
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Address Line | 306 N WILLOW AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-5549
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Country | US
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Telephone | 931-528-5788
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Fax | 931-528-5789
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Authorized Official
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Title or Position | MANAGING MEMBER/OWNER
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Name | MR. JEFFREY T APPLE
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Credential | ATP
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Telephone | 931-528-5788
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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 | 489
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License Number State | TN
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