Provider Demographics
NPI:1043034036
Name:DESERT MOBILITY EQUIPMENT LLC
Entity type:Organization
Organization Name:DESERT MOBILITY EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-389-7787
Mailing Address - Street 1:1531 FORD DR
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-1602
Mailing Address - Country:US
Mailing Address - Phone:760-389-7787
Mailing Address - Fax:
Practice Address - Street 1:1531 FORD DR
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1602
Practice Address - Country:US
Practice Address - Phone:760-389-7787
Practice Address - Fax:760-389-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies