Provider Demographics
NPI:1609450295
Name:MGR TECHNOLOGIES, INC
Entity Type:Organization
Organization Name:MGR TECHNOLOGIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:T
Authorized Official - Last Name:RUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-592-3232
Mailing Address - Street 1:PO BOX 6831
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33583-6831
Mailing Address - Country:US
Mailing Address - Phone:813-592-3232
Mailing Address - Fax:
Practice Address - Street 1:527 DUNAWAY DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-6780
Practice Address - Country:US
Practice Address - Phone:813-592-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MGR TECHNOLOGIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care