MEDICARE: MGC MOBILE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1710832217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MGC MOBILE SERVICES LLC

Provider Business Mailing Address
First Line	:	3544 METTING RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-1339
Country	:	US
Telephone Number	:	910-742-0142
Fax Number	:

Provider Business Practice Location Address
First Line	:	3544 METTING RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-1339
Country	:	US
Telephone Number	:	910-742-0142
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	QUASHEERA GAMBLE
Credential	:
Telephone Number	:	910-742-0142

Provider Enumeration Date	:	02/28/2026
Last Update Date	:	02/28/2026

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