MEDICARE: MOBILENETWORK24.COM, 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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1588343628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILENETWORK24.COM, LLC

Provider Business Mailing Address
First Line	:	PO BOX 13353
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45413-0353
Country	:	US
Telephone Number	:	937-672-0894
Fax Number	:

Provider Business Practice Location Address
First Line	:	2554 NEEDMORE RD # C2
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-4204
Country	:	US
Telephone Number	:	937-672-0894
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. KENNETH WAYNE COLLIER JR.
Credential	:
Telephone Number	:	937-672-0894

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	07/17/2023

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