Provider Demographics
NPI:1528060332
Name:JC MOBILITY SOLUTIONS LLC
Entity type:Organization
Organization Name:JC MOBILITY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-655-2000
Mailing Address - Street 1:51B MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:ME
Mailing Address - Zip Code:04071-6520
Mailing Address - Country:US
Mailing Address - Phone:207-655-2000
Mailing Address - Fax:207-655-2032
Practice Address - Street 1:51B MAIN ST
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:ME
Practice Address - Zip Code:04071-6520
Practice Address - Country:US
Practice Address - Phone:207-655-2000
Practice Address - Fax:207-655-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30763602Medicaid
ME431827000Medicaid
ME5389230001Medicare ID - Type Unspecified