Organization
LIFESTYLE SCOOTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY DEAN SHELLEY (PRESIDENT)
(317) 862-2870
Entity
Organization
Contact information
Practice address
8814 SOUTHEASTERN AVE, INDIANAPOLIS, IN 46239-1341
(317) 862-2870
(317) 862-2886
Mailing address
8814 SOUTHEASTERN AVE, INDIANAPOLIS, IN 46239-1341
(317) 862-2870
(317) 862-2886
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
69000668A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200984760A
—
IN
Enumeration date
01/20/2010
Last updated
11/12/2010
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