DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: THE MOG LLC

MEDICARE: THE MOG LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerAT241ME
22255A2300XAthletic TrainerAT500ME
32255A2300XAthletic TrainerAT433ME

General Provider Information

NPI Number : 1295242923
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE MOG LLC
Provider Business Mailing Address
First Line : 125 JOHN ROBERTS RD STE 16
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-6983
Country : US
Telephone Number : 207-347-3030
Fax Number : 207-536-4449
Provider Business Practice Location Address
First Line : 125 JOHN ROBERTS RD STE 16
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-6983
Country : US
Telephone Number : 207-347-3030
Fax Number : 207-536-4449
Authorized Official
Title or Position : OWNER
Name : CHRISTOPHER S PRIBISH
Credential : ATC, CSCS, CSAC
Telephone Number : 207-347-3030
Provider Enumeration Date : 01/03/2018
Last Update Date : 06/16/2018

Similar Medicare Providers

1841707551 — ADAM T HANRAHAN
Practice Location Address:
125 JOHN ROBERTS RD STE 16
SOUTH PORTLAND, ME
04106-6983
Practice Phone: 207-347-3030
Practice Fax: 207-536-4449
1700643384 — INFINITE CAPACITY PHYSICAL THERAPY LLC
Practice Location Address:
125 JOHN ROBERTS RD STE 15
SOUTH PORTLAND, ME
04106-6983
Practice Phone: 724-584-3307
Practice Fax:
1538658703 — AMY C MILLS FNP
Practice Location Address:
1054 BOLD SPRINGS RD
SOUTH BOSTON, VA
24592-6983
Practice Phone: 434-404-3970
Practice Fax: 434-404-3371
1679926828 — JENNIFER WATTS NP
Practice Location Address:
100 FODEN ROAD - EAST , SUITE 203
SOUTH PORTLAND, ME
04106
Practice Phone: 207-874-1489
Practice Fax:
1578683280 — VNA HOME HEALTH & HOSPICE
Practice Location Address:
225 GORHAM RD STE 200
SOUTH PORTLAND, ME
04106-2462
Practice Phone: 800-757-3326
Practice Fax: 207-400-8891
1447985064 — VNA HOME HEALTH & HOSPICE
Practice Location Address:
225 GORHAM RD STE 200
SOUTH PORTLAND, ME
04106-2462
Practice Phone: 207-400-8700
Practice Fax:

Directions to “THE MOG LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.