Provider Demographics
NPI:1447668447
Name:MOBILITY MARKETPLACE, LLC
Entity type:Organization
Organization Name:MOBILITY MARKETPLACE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHLEMBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-554-5857
Mailing Address - Street 1:625 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2607
Mailing Address - Country:US
Mailing Address - Phone:614-486-8100
Mailing Address - Fax:
Practice Address - Street 1:625 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2607
Practice Address - Country:US
Practice Address - Phone:614-486-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QM1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1102XAmbulatory Health Care FacilitiesClinic/CenterMilitary Outpatient Operational (Transportable) Component