Provider Demographics
NPI:1427413350
Name:JUSGO MOBILITI
Entity type:Organization
Organization Name:JUSGO MOBILITI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:818-261-8511
Mailing Address - Street 1:17913 FLAGLER DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-7639
Mailing Address - Country:US
Mailing Address - Phone:661-312-5389
Mailing Address - Fax:
Practice Address - Street 1:17913 FLAGLER DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-7639
Practice Address - Country:US
Practice Address - Phone:661-312-5389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies