Provider Demographics
NPI:1518220029
Name:MP MEDICAL LLC
Entity Type:Organization
Organization Name:MP MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-717-3035
Mailing Address - Street 1:122 ONDINE LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-9006
Mailing Address - Country:US
Mailing Address - Phone:504-717-3035
Mailing Address - Fax:
Practice Address - Street 1:122 ONDINE LN
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-9006
Practice Address - Country:US
Practice Address - Phone:504-717-3035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADME.000202332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies