Provider Demographics
NPI:1790667665
Name:SEMO MOBILITY
Entity type:Organization
Organization Name:SEMO MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:LACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-986-8277
Mailing Address - Street 1:253 ROTH DR
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63780-8132
Mailing Address - Country:US
Mailing Address - Phone:573-986-8277
Mailing Address - Fax:
Practice Address - Street 1:253 ROTH DR
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:MO
Practice Address - Zip Code:63780-8132
Practice Address - Country:US
Practice Address - Phone:573-986-8277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty