Organization Name: | PRESCOTT MOBILILTY STORE INC |
NPI Number: | 1023105186 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDSAY JANE SHERRARD (OWNER) |
Mailing Address: | 609 Miller Valley Rd Prescott |
State: | AZ US |
Postal Code: | 863012315 |
Phone Number: | 9285410120 |
Fax Number: | 9285410122 |
NPI Enumeration Date: | 10/09/2006 |
NPI Last Update Date: | 10/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 5200-61900-16 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |