Provider Demographics
NPI:1316931215
Name:MOBILE MED CARE INC
Entity type:Organization
Organization Name:MOBILE MED CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-492-1800
Mailing Address - Street 1:14306 W 100TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-1236
Mailing Address - Country:US
Mailing Address - Phone:913-492-1800
Mailing Address - Fax:913-438-5625
Practice Address - Street 1:14306 W 100TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-1236
Practice Address - Country:US
Practice Address - Phone:913-492-1800
Practice Address - Fax:913-438-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS118005OtherKS B/C BLUE SHIELD
KS118045OtherKS B/C BLUE SHIELD
KS118045OtherKS B/C BLUE SHIELD
KS0149470009Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
KS0149470011Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
KS0149470001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
KS118005OtherKS B/C BLUE SHIELD
MO0149470003Medicare ID - Type UnspecifiedMEDICARE
MO0149470010Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
KS0149470008Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MO0149470005Medicare ID - Type UnspecifiedMEDICARE
KS0149470007Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER