Provider Demographics
NPI:1053384602
Name:NATIONAL SEATING & MOBILITY, INC.
Entity type:Organization
Organization Name:NATIONAL SEATING & MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATUKEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-756-2268
Mailing Address - Street 1:5959 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 443
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37241-2245
Mailing Address - Country:US
Mailing Address - Phone:423-756-2268
Mailing Address - Fax:423-266-9690
Practice Address - Street 1:1936 SOUTH LYNHURST DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-4636
Practice Address - Country:US
Practice Address - Phone:317-487-0758
Practice Address - Fax:800-240-5892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0996598Medicaid
IN100194330AMedicaid
IN56393OtherIN CHILDREN'S SPECIAL HEALTH CARE SERVICES
IN200099080DOtherINDIANA WAIVER
IL=========002Medicaid
IL=========002Medicaid