Provider Demographics
NPI:1760094361
Name:M. R. MACK & HEALTH LLC
Entity Type:Organization
Organization Name:M. R. MACK & HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANTELL
Authorized Official - Middle Name:
Authorized Official - Last Name:MACK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:941-666-0425
Mailing Address - Street 1:4809 NE 2ND LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-1517
Mailing Address - Country:US
Mailing Address - Phone:941-666-0425
Mailing Address - Fax:
Practice Address - Street 1:4809 NE 2ND LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-1517
Practice Address - Country:US
Practice Address - Phone:941-666-0425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care