Healthcare Provider Details

I. General information

NPI: 1174440036
Provider Name (Legal Business Name): MAG TECH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 SOUTH RD
HIGH POINT NC
27262-8107
US

IV. Provider business mailing address

621 SOUTH RD
HIGH POINT NC
27262-8107
US

V. Phone/Fax

Practice location:
  • Phone: 213-734-3125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MELVIN GONZALEZ
Title or Position: DIRECTOR
Credential:
Phone: 213-734-3125