Provider Demographics
NPI:1194914788
Name:MEDITECH MOBILITY
Entity type:Organization
Organization Name:MEDITECH MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:FORYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-750-8716
Mailing Address - Street 1:630 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-1726
Mailing Address - Country:US
Mailing Address - Phone:509-765-8267
Mailing Address - Fax:509-764-4300
Practice Address - Street 1:630 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-1726
Practice Address - Country:US
Practice Address - Phone:509-765-8267
Practice Address - Fax:509-764-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies