Provider Demographics
NPI:1417927997
Name:UNITED SEATING AND MOBILITY LLC
Entity type:Organization
Organization Name:UNITED SEATING AND MOBILITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR LICENSING & CREDENTIALING MGR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLESCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-447-7515
Mailing Address - Street 1:805 BROOK ST STE 402
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3431
Mailing Address - Country:US
Mailing Address - Phone:314-447-7500
Mailing Address - Fax:855-375-7973
Practice Address - Street 1:21099 SW 115TH AVE
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-6846
Practice Address - Country:US
Practice Address - Phone:503-582-1955
Practice Address - Fax:503-612-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR019878-90332B00000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR228833OtherDOCS-OMAP
OR276581OtherAETNA NATIONAL HMO
OR141330100OtherUS DEPT OF LABOR
OR0178400001OtherPACIFICARE OF OR
OR228883OtherMARION POLK HEALTH PLAN
OR228883OtherFAMILYCARE OR PREMIERCARE
OR7282299OtherAETNA NATIONAL NON-HMO
OR228811OtherMID ROGUE IPA
OR810070000OtherREGENCE BCBS OF OR
OR247574Medicaid
OR407099OtherHUMANA CHOICE CARE
OR251910864OtherGREAT WEST LIFE & ANNUITY
ORJ0112-01OtherPACIFICSOURCE HEALTH PLAN
OR7282299OtherAETNA NATIONAL NON-HMO