Provider Demographics
NPI:1801416961
Name:GROUNDED IN TECH, LLC
Entity Type:Organization
Organization Name:GROUNDED IN TECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHETT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCNULTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-885-6110
Mailing Address - Street 1:445 BENT ST
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-2329
Mailing Address - Country:US
Mailing Address - Phone:949-885-6110
Mailing Address - Fax:
Practice Address - Street 1:445 BENT ST
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2329
Practice Address - Country:US
Practice Address - Phone:949-885-6110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-19
Last Update Date:2020-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies