Provider Demographics
NPI:1447344627
Name:MEDICAL MOBILITY EQUIPMENT
Entity type:Organization
Organization Name:MEDICAL MOBILITY EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MR
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-268-8300
Mailing Address - Street 1:2321 E MATTHEWS AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4415
Mailing Address - Country:US
Mailing Address - Phone:870-268-8300
Mailing Address - Fax:870-268-8932
Practice Address - Street 1:2321 E MATTHEWS AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4415
Practice Address - Country:US
Practice Address - Phone:870-268-8300
Practice Address - Fax:870-268-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00497332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4631690001Medicare ID - Type Unspecified