MEDICARE: MOBILITY DESIGNS

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	332BC3200X	Customized Equipment (DME)	20000596130	GA

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	:	1952357873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILITY DESIGNS

Provider Business Mailing Address
First Line	:	3715 NORTHCREST RD
Second Line	:	SUITE 28
City	:	ATLANTA
State	:	GA
Zip	:	30340-3411
Country	:	US
Telephone Number	:	770-458-1329
Fax Number	:	770-457-3229

Provider Business Practice Location Address
First Line	:	3715 NORTHCREST RD
Second Line	:	SUITE 28
City	:	ATLANTA
State	:	GA
Zip	:	30340-3411
Country	:	US
Telephone Number	:	770-458-1329
Fax Number	:	770-457-3229

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LARRY EZZARD
Credential	:
Telephone Number	:	770-458-1329

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	04/17/2013

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