Provider Demographics
NPI:1457196784
Name:ABSOLUTE MOBILITY DRIVER
Entity type:Organization
Organization Name:ABSOLUTE MOBILITY DRIVER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-321-7985
Mailing Address - Street 1:285 ROBERT AVE
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2980
Mailing Address - Country:US
Mailing Address - Phone:425-321-7985
Mailing Address - Fax:
Practice Address - Street 1:285 ROBERT AVE
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2980
Practice Address - Country:US
Practice Address - Phone:425-321-7985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle