Organization
MOBILITY PLUS HOMECARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY ALLAN AVERITT (PRESIDENT)
(270) 360-0486
Entity
Organization
Contact information
Practice address
200 SYCAMORE ST, SUITE 136, ELIZABETHTOWN, KY 42701-2469
(270) 360-0486
(270) 360-1841
Mailing address
200 SYCAMORE ST, SUITE 136, ELIZABETHTOWN, KY 42701-2469
(270) 360-0486
(270) 360-1841
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
221831
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000201522
ANTHEM BLUE CROSS
KY
01
—
1129616
PASSPORT HEALTH PLAN
KY
01
—
247572000
PASSPORT ADVANTAGE
KY
05
—
90001686
—
KY
Enumeration date
03/05/2007
Last updated
12/18/2015
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