Provider Demographics
NPI:1710322102
Name:MAGITEK, LLC
Entity Type:Organization
Organization Name:MAGITEK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LYLE
Authorized Official - Last Name:LAUTZENHISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-488-4447
Mailing Address - Street 1:5618 COUNTY ROAD 6
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:IN
Mailing Address - Zip Code:46742-9730
Mailing Address - Country:US
Mailing Address - Phone:260-488-2226
Mailing Address - Fax:
Practice Address - Street 1:5618 COUNTY ROAD 6
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:IN
Practice Address - Zip Code:46742-9730
Practice Address - Country:US
Practice Address - Phone:260-488-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment