Advanced Mobility of Bend, LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Bend, OR
NPI 1790701258 · NPPES record last updated Jul 25, 2008
Key facts
- NPI
- 1790701258
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 07-00000460 (OR)
- Legal business name
- ADVANCED MOBILITY OF BEND, LLC
- Practice address
- 1045 NE 3Rd St
Bend, OR 97701-4526 - Phone
- (541) 382-6016
- Fax
- (541) 382-2987
- NPI assigned
- Jul 15, 2006
- Reactivated
- Jul 25, 2008
- Organization subpart
- No
Authorized official
- Name
- Lisa L. Cummins
- Title
- Owner
- Phone
- (541) 382-6016
National Provider Directory
Locations
1045 NE 3rd St
Bend, OR 97701
Phone (541) 382-6016
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 07-00000460 | OR | Yes |
Addresses
Primary practice location
1045 NE 3Rd St
Bend, OR 97701-4526
Mailing address
1045 NE 3Rd St
Bend, OR 97701-4526
Phone (541) 382-6016
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 278144 | Medicaid | OR | |
| 0208047 | Other | WA | L&I |
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All providers in Bend, OR · Durable Medical Equipment & Medical Supplies in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.