Provider Demographics
NPI:1316982143
Name:MOBILITY CENTRAL, INC.
Entity type:Organization
Organization Name:MOBILITY CENTRAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-916-0670
Mailing Address - Street 1:400 OLDE TOWNE RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3732
Mailing Address - Country:US
Mailing Address - Phone:205-916-0670
Mailing Address - Fax:205-940-2299
Practice Address - Street 1:400 OLDE TOWNE RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-3732
Practice Address - Country:US
Practice Address - Phone:205-916-0670
Practice Address - Fax:205-940-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL05017284332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009969285Medicaid
AL51521309OtherBLUECROSS BLUESHIELD
AL009969285Medicaid
AL009969285Medicaid