Provider Demographics
NPI:1841524303
Name:MOBILITY PLUS MEDICAL SUPPLY
Entity type:Organization
Organization Name:MOBILITY PLUS MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LASHAWNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-304-8308
Mailing Address - Street 1:3904 LAREDO CIR
Mailing Address - Street 2:1013-B W. MCNEESE ST.
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-0952
Mailing Address - Country:US
Mailing Address - Phone:337-304-8308
Mailing Address - Fax:
Practice Address - Street 1:3904 LAREDO CIR
Practice Address - Street 2:1013-B W. MCNEESE ST.
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-0952
Practice Address - Country:US
Practice Address - Phone:337-304-8308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies