MEDICARE: M. C. MOBILITY SYSTEMS INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171WV0202X	Vehicle Modifications Contractor
2	332BC3200X	Customized Equipment (DME)
3	332B00000X	Durable Medical Equipment & Medical Supplies

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

General Provider Information

NPI Number	:	1902211220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M. C. MOBILITY SYSTEMS INC.

Provider Business Mailing Address
First Line	:	7588 TYLER BLVD
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4871
Country	:	US
Telephone Number	:	440-951-4335
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 VALLEY ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45404-1839
Country	:	US
Telephone Number	:	937-222-5001
Fax Number	:	937-222-4001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CARMEN PATERNITI
Credential	:
Telephone Number	:	440-951-4335

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	06/25/2014

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