Provider Demographics
NPI:1376322727
Name:HUNTTING MACCO PLLC
Entity Type:Organization
Organization Name:HUNTTING MACCO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MACCO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-491-5316
Mailing Address - Street 1:3524 HERONS CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-7793
Mailing Address - Country:US
Mailing Address - Phone:510-491-5316
Mailing Address - Fax:
Practice Address - Street 1:8040 S VIRGINIA ST STE 6
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8939
Practice Address - Country:US
Practice Address - Phone:510-491-5316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1598243396Medicaid