Provider Demographics
NPI:1992924948
Name:KEY MOBILITY SERVICES LTD.
Entity type:Organization
Organization Name:KEY MOBILITY SERVICES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STORE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-374-3226
Mailing Address - Street 1:1944 US ROUTE 68 N
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-9552
Mailing Address - Country:US
Mailing Address - Phone:937-374-3226
Mailing Address - Fax:937-374-4460
Practice Address - Street 1:1944 US ROUTE 68 N
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-9552
Practice Address - Country:US
Practice Address - Phone:937-374-3226
Practice Address - Fax:937-374-4460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH29031606332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2068471Medicaid
OH2068471Medicaid