Organization
FIRST COAST MOBILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAN GORDON VAN KIRK (OWNER)
(904) 829-2846
Entity
Organization
Contact information
Practice address
3975 STATE ROAD 16, ST AUGUSTINE, FL 32092-0730
(904) 829-2846
Mailing address
3975 STATE ROAD 16, ST AUGUSTINE, FL 32092-0730
(904) 829-2846
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/30/2010
Last updated
12/30/2010
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