Provider Demographics
NPI:1871953620
Name:PEDIATRIC MOBILITY INNOVATIONS, INC.
Entity type:Organization
Organization Name:PEDIATRIC MOBILITY INNOVATIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:DOWNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-399-1142
Mailing Address - Street 1:4458 AUGUSTA RD
Mailing Address - Street 2:STE 1B
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-7155
Mailing Address - Country:US
Mailing Address - Phone:803-399-1142
Mailing Address - Fax:803-399-1946
Practice Address - Street 1:4458 AUGUSTA RD
Practice Address - Street 2:STE 1B
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-7155
Practice Address - Country:US
Practice Address - Phone:803-399-1142
Practice Address - Fax:803-399-1946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment