MEDICARE: MOBILE MEDICAL SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician
2	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023087616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	306 S BELT HWY
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-3418
Country	:	US
Telephone Number	:	816-232-2727
Fax Number	:	816-232-2771

Provider Business Practice Location Address
First Line	:	3622 CHARLES ST
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-3424
Country	:	US
Telephone Number	:	816-232-2727
Fax Number	:	816-232-2771

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ZACHARY B EVANS
Credential	:
Telephone Number	:	816-232-2727

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	11/01/2011

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Directions to “MOBILE MEDICAL SERVICES INC ” Practice Location

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