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General NPI Number Information
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NPI Number | 1376297184
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Entity Type | Organization
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Legal Business Name | MGALLAN LLC
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 8810 COMMODITY CIR STE 1
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City | ORLANDO
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State | FL
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Zip | 32819-9065
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Country | US
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Telephone | 910-297-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 1733 DAWSON ST
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City | WILMINGTON
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State | NC
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Zip | 28403-2326
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MARTIN GALLAN
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Credential |
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Telephone | 910-297-6110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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