MEDICARE: ACCESSIBLE MOBILITY CENTER, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1215366760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESSIBLE MOBILITY CENTER, LLC

Provider Business Mailing Address
First Line	:	640 CONGAREE RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-3518
Country	:	US
Telephone Number	:	864-315-1899
Fax Number	:	864-509-6288

Provider Business Practice Location Address
First Line	:	640 CONGAREE RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-3518
Country	:	US
Telephone Number	:	864-315-1899
Fax Number	:

Authorized Official
Title or Position	:	ACCESSIBLE EQUIPMENT SPECIALIST
Name	:	MR. JON COLBERT
Credential	:
Telephone Number	:	864-315-1899

Provider Enumeration Date	:	11/05/2013
Last Update Date	:	11/05/2013

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