Organization
ACTIVE MOBILITY OF OHIO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY C PETERSON (PRESIDENT)
(419) 478-1881
Entity
Organization
Contact information
Practice address
5702 OPPORTUNITY DR, TOLEDO, OH 43612-2903
(419) 478-1881
(419) 478-1919
Mailing address
5702 OPPORTUNITY DR, TOLEDO, OH 43612-2903
(419) 478-1881
(419) 478-1919
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03073
PARAMOUNT HEALTH CARE
OH
05
—
0508418
—
OH
01
—
873065395
MEDICAID
MI
Enumeration date
06/04/2006
Last updated
03/08/2010
Update your record
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