Provider Demographics
NPI:1679875363
Name:SIEBERT MOBILTY INC.
Entity type:Organization
Organization Name:SIEBERT MOBILTY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENRAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLTON
Authorized Official - Middle Name:
Authorized Official - Last Name:FINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-316-2466
Mailing Address - Street 1:712 HIGHWAY 5 N
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-8558
Mailing Address - Country:US
Mailing Address - Phone:501-316-2466
Mailing Address - Fax:
Practice Address - Street 1:712 HWY 5 N
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019
Practice Address - Country:US
Practice Address - Phone:501-316-2466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR315692-62-001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR168186784Medicaid