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General NPI Number Information
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NPI Number | 1144491648
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Entity Type | Organization
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Legal Business Name | M & C CONSTRUCTION, LLC
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 9011 WOODRUN LN
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City | PENSACOLA
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State | FL
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Zip | 32514-5513
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Country | US
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Telephone | 850-417-7824
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Fax |
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Provider Business Mailing Address
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Address Line | 9011 WOODRUN LN
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City | PENSACOLA
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State | FL
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Zip | 32514-5513
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Country | US
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Telephone | 850-417-7824
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS
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Name | MR. EUDER A. COUTINHO
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Credential |
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Telephone | 850-232-8582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | CBC1254272
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License Number State | FL
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