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General NPI Number Information
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NPI Number | 1760094361
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Entity Type | Organization
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Legal Business Name | M. R. MACK & HEALTH LLC
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 4809 NE 2ND LOOP
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City | OCALA
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State | FL
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Zip | 34470-1517
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Country | US
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Telephone | 941-666-0425
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Fax |
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Provider Business Mailing Address
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Address Line | 4809 NE 2ND LOOP
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City | OCALA
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State | FL
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Zip | 34470-1517
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Country | US
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Telephone | 941-666-0425
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MANTELL MACK JR.
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Credential |
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Telephone | 941-666-0425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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