Healthcare Provider Details

I. General information

NPI: 1215443320
Provider Name (Legal Business Name): MNR INDUSTRIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2017
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N EAST PLZ
NORTH EAST MD
21901-3633
US

IV. Provider business mailing address

1505 E CHURCHVILLE RD
BEL AIR MD
21014-4742
US

V. Phone/Fax

Practice location:
  • Phone: 443-485-6213
  • Fax:
Mailing address:
  • Phone: 410-420-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY MCGILLEN
Title or Position: DIRECTOR OF BILLING & CREDENTIALING
Credential:
Phone: 410-420-6970