Provider Demographics
NPI:1871331546
Name:MEDPRO MOBILE SERVICES LLC
Entity type:Organization
Organization Name:MEDPRO MOBILE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOMIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-372-5872
Mailing Address - Street 1:1234 STANLEY AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-5601
Mailing Address - Country:US
Mailing Address - Phone:929-372-5872
Mailing Address - Fax:
Practice Address - Street 1:1234 STANLEY AVE APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-5601
Practice Address - Country:US
Practice Address - Phone:929-372-5872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service