Provider Demographics
NPI:1376836973
Name:LOGZ'S LLC
Entity type:Organization
Organization Name:LOGZ'S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCKEEVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-965-4213
Mailing Address - Street 1:185 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-4407
Mailing Address - Country:US
Mailing Address - Phone:860-965-4213
Mailing Address - Fax:888-318-5670
Practice Address - Street 1:185 BROADWAY
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-4407
Practice Address - Country:US
Practice Address - Phone:860-965-4213
Practice Address - Fax:888-318-5670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory