Provider Demographics
NPI:1235432741
Name:MED-MEN LLC
Entity Type:Organization
Organization Name:MED-MEN LLC
Other - Org Name:SOUND-N-SNORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:NAGLE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:253-224-2624
Mailing Address - Street 1:2522 N PROCTOR ST
Mailing Address - Street 2:468
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5338
Mailing Address - Country:US
Mailing Address - Phone:253-376-7605
Mailing Address - Fax:253-276-1792
Practice Address - Street 1:2522 N PROCTOR ST
Practice Address - Street 2:468
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-5338
Practice Address - Country:US
Practice Address - Phone:253-376-7605
Practice Address - Fax:253-276-1792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory