Provider Demographics
NPI:1588103196
Name:R&J MOBILITY SERVICE, LLC
Entity type:Organization
Organization Name:R&J MOBILITY SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRYBOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-702-5043
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97351-0128
Mailing Address - Country:US
Mailing Address - Phone:503-838-5520
Mailing Address - Fax:503-838-4710
Practice Address - Street 1:155 E ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OR
Practice Address - Zip Code:97351-2410
Practice Address - Country:US
Practice Address - Phone:503-838-5520
Practice Address - Fax:503-838-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment