Wholesaler and Distributor Information

Orders for the following models are accepted for immediate delivery:

Apply for account and order using these forms. Fax to (847) 735-9290.

Account Applications

Account Order Forms

Credit Card Order Forms

Reimbursement

According to the SADMERC's determination Medicare HCPCS codes to bill the four Durable Medical Equipment Regional carriers (DMERCs) are: E0110 (pair) and E0111 (each) . To view our HCPCS coding determination letter Click Here.

Use this form to make Wholesale Purchase inquiries. Field names listed in this color are required to send the form.

Business Name:

Contact's First Name:

Contact's Last Name:

Title:

Email Address:

Street:

City:

State/Province:

Zip/Postal Code: -

Phone: () - - ext.

Fax: () - -

How did you hear about us?

Inquiry:

STRONGARM™ Mobility
13000 West Heiden,
Ste. 3209
Lake Bluff 60044 USA

Customer Service:
(888) 482-1569

Professional Inquiries:
(847) 482-1569

Fax: (847) 735-9290
sales@strongarmmobility.com