MEDICARE: M&C DYNAMICS 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1891568580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M&C DYNAMICS LLC

Provider Business Mailing Address
First Line	:	4330 WINDING WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-4416
Country	:	US
Telephone Number	:	279-219-4100
Fax Number	:	916-234-6628

Provider Business Practice Location Address
First Line	:	4330 WINDING WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-4416
Country	:	US
Telephone Number	:	279-219-4100
Fax Number	:	916-234-6628

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. MARK PERRY GALLAGHER
Credential	:
Telephone Number	:	279-219-4100

Provider Enumeration Date	:	11/03/2023
Last Update Date	:	11/03/2023

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