Organization
BENNETT MOBILITY PRODUCTS LLC
Active
Other names
Bennett Mobility Products
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT D BENNETT (CEO/MANAGER/SINGLE OWNER)
(912) 807-6625
Entity
Organization
Contact information
Practice address
638 GORDON ST, BLACKSHEAR, GA 31516-1208
(912) 807-6625
(912) 807-0212
Mailing address
638 GORDON ST, BLACKSHEAR, GA 31516-1208
(912) 807-6625
(912) 807-0212
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
2010000805
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003108583A
—
GA
05
—
879144878A
—
GA
Enumeration date
01/21/2011
Last updated
10/02/2012
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