Provider Demographics
NPI:1982918827
Name:WILLIAMSBURG MOBILITY LLC
Entity type:Organization
Organization Name:WILLIAMSBURG MOBILITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:BUNTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-715-1481
Mailing Address - Street 1:109 SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185
Mailing Address - Country:US
Mailing Address - Phone:757-645-4255
Mailing Address - Fax:
Practice Address - Street 1:156 STRAWBERRY PLAINS RD
Practice Address - Street 2:SUITE D
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-3409
Practice Address - Country:US
Practice Address - Phone:757-645-4255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies