Organization
THE MOBILITY DEPOT, LLC
Active
Other names
MOBILITY DEPOT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH EDWARD MENVILLE (OWNER)
(225) 215-2222
Entity
Organization
Contact information
Practice address
7931 ONE CALAIS AVE, BATON ROUGE, LA 70809-3403
(225) 215-2222
(225) 215-2248
Mailing address
7931 ONE CALAIS AVE, BATON ROUGE, LA 70809-3403
(225) 215-2222
(225) 215-2248
Taxonomy
Speciality
Code
Description
License number
State
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12950
LA REHAB SERVICES
LA
05
—
14384211
—
LA
01
—
602016103
US DEPT OF LABOR
LA
01
—
F8861
BLUECROSS BLUESHIELD
LA
Enumeration date
04/18/2006
Last updated
07/08/2019
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