PRESIDENTIAL MOBILITY NPI 1710975008

NPI Information

NPI: 1710975008
Provider Name: PRESIDENTIAL MOBILITY
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
2889 N COLLEGE AVE
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 332-4990
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PRESIDENTIAL MOBILITY is a durable medical equipment medical supplies in Fayetteville, AR. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. PRESIDENTIAL MOBILITY NPI is 1710975008. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2889 N COLLEGE AVE
FAYETTEVILLE, AR
ZIP 72703-413
Phone: (479) 332-4990
Fax: (479) 332-4290

The provider's authorized official is Robin Grider .
The authorized official title is Dme Manager and has the following contact phone number (479) 330-4990.

The enumeration date for this NPI number is 10/11/2005 and was last updated on 3/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	171W00000X	Contractor		No
2	171WH0202X	Contractor	Home Modifications	No
3	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	No
4	332B00000X	Durable Medical Equipment & Medical Supplies		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	48128	OTHER	ARKANSAS	BLUE CROSS BLUE SHIELD
2	130311772	MEDICAID	ARKANSAS
3	137085716	MEDICAID	ARKANSAS
4	141768784	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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