Provider Demographics
NPI:1902647886
Name:MOBICLINIX DME, LLC
Entity type:Organization
Organization Name:MOBICLINIX DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-315-3845
Mailing Address - Street 1:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:SERGEANT BLUFF
Mailing Address - State:IA
Mailing Address - Zip Code:51054-0104
Mailing Address - Country:US
Mailing Address - Phone:888-315-3845
Mailing Address - Fax:712-248-8720
Practice Address - Street 1:4400 SERGEANT RD STE 134
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4760
Practice Address - Country:US
Practice Address - Phone:888-315-3845
Practice Address - Fax:712-248-8720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition