Provider Demographics
NPI: | 1053589150 |
---|---|
Name: | SFA MOBILITY LLC |
Entity type: | Organization |
Organization Name: | SFA MOBILITY LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANNA |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | MICHOWSKA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 361-655-9242 |
Mailing Address - Street 1: | 1329 N UNIVERSITY DR |
Mailing Address - Street 2: | SUITE F-4 |
Mailing Address - City: | NACOGDOCHES |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75961-4232 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 936-559-5522 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1329 N UNIVERSITY DR |
Practice Address - Street 2: | SUITE F-4 |
Practice Address - City: | NACOGDOCHES |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75961-4232 |
Practice Address - Country: | US |
Practice Address - Phone: | 936-559-5522 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-02-12 |
Last Update Date: | 2008-02-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 32034522279 | 332BX2000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |