Healthcare Provider Details

I. General information

NPI: 1124580899
Provider Name (Legal Business Name): PMGG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 E CARMEL DR
CARMEL IN
46032-2635
US

IV. Provider business mailing address

244 E CARMEL DR
CARMEL IN
46032-2635
US

V. Phone/Fax

Practice location:
  • Phone: 317-975-1973
  • Fax: 317-975-1973
Mailing address:
  • Phone: 317-975-1973
  • Fax: 317-975-1973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP E NUNN
Title or Position: MEMBER/MANAGER
Credential:
Phone: 317-975-1973