Provider Demographics
NPI:1730965963
Name:MOBILE MEDICAL EQUIPMENT REPAIR, LLC
Entity type:Organization
Organization Name:MOBILE MEDICAL EQUIPMENT REPAIR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-372-1355
Mailing Address - Street 1:2043 MAJESTIC PINE CT NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4023
Mailing Address - Country:US
Mailing Address - Phone:772-924-7334
Mailing Address - Fax:
Practice Address - Street 1:1707 CANOVA ST SE STE 5
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-3925
Practice Address - Country:US
Practice Address - Phone:321-372-1355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment