Prescott Mobililty Store Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5200-61900-16 Issued in AZ

Legal business name

PRESCOTT MOBILILTY STORE INC

Practice address

609 Miller Valley Rd
Prescott, AZ 86301-2315

Phone

(928) 541-0120

Fax

(928) 541-0122

NPI assigned

Oct 9, 2006

Last updated

Oct 15, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lindsay Jane Sherrard

Title

Owner

Phone

(928) 541-0120

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1023105186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 MILLER VALLEY RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012315",
            "telephone_number": "928-541-0120",
            "fax_number": "928-541-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 MILLER VALLEY RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012315",
            "telephone_number": "928-541-0120",
            "fax_number": "928-541-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT MOBILILTY STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "SHERRARD",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-541-0120",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "5200-61900-16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.