Provider Demographics
NPI:1306313283
Name:SKILLED MOBILITY, LLC
Entity type:Organization
Organization Name:SKILLED MOBILITY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ATP
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-846-3155
Mailing Address - Street 1:135 OYSTER CREEK DR STE H
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4118
Mailing Address - Country:US
Mailing Address - Phone:832-914-0991
Mailing Address - Fax:
Practice Address - Street 1:135 OYSTER CREEK DR STE H
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4118
Practice Address - Country:US
Practice Address - Phone:832-914-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment