=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861557621
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELECTRIC MOBILITY CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4000 EAGLE POINT CORPORATE DR
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35240-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-314-5716
-----------------------------------------------------
Fax | 205-314-5728
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 591 MANTUA BLVD
-----------------------------------------------------
City | SEWELL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08080-1016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-468-1000
-----------------------------------------------------
Fax | 856-415-1796
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE VICE PRESIDENT OF FINANCE
-----------------------------------------------------
Name | MR. ART REA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 856-468-1000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 718
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------