Advanced Mobility Repair

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

602621899 Issued in WA

Legal business name

ADVANCED MOBILITY REPAIR

Practice address

21645 Oregon TRL
Centralia, WA 98531-9617

Phone

(360) 219-1102

Fax

(360) 237-0561

NPI assigned

Oct 9, 2006

Last updated

Jun 16, 2008By 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

Kazon Rotz

Title

Owner

Phone

(360) 219-1102

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": "1213574400000",
    "number": "1487741617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 NW LOUISIANA AVE",
            "address_2": "SUITE 140",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985321749",
            "telephone_number": "360-219-1102",
            "fax_number": "360-237-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21645 OREGON TRL",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319617",
            "telephone_number": "360-219-1102",
            "fax_number": "360-237-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MOBILITY REPAIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "ROTZ",
        "authorized_official_first_name": "KAZON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-219-1102"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "602621899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Centralia, WA
• Providers in Centralia, WA by specialty
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.