Organization
ADVANCED MOBILITY MEDICAL EQUIP SUPPLY
Active
Organization
ADVANCED MOBILITY MEDICAL EQUIP SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE A ICHEGBO (OWNER ADM MANAGER)
(334) 792-9357
Entity
Organization
Contact information
Practice address
126 SOUTH ALICE STREET, SUITE 4, DOTHAN, AL 36301-1652
(334) 792-9357
(334) 792-9367
Mailing address
126 SOUTH ALICE STREET, SUITE 4, DOTHAN, AL 36301-1652
(334) 792-9357
(334) 792-9367
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009935224
—
AL
01
—
51532500
BC BS
AL
Enumeration date
12/20/2006
Last updated
06/20/2008
Update your record
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