Provider Demographics
NPI:1780350777
Name:MPA MEDICAL LLC
Entity type:Organization
Organization Name:MPA MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-404-4476
Mailing Address - Street 1:289 WHITE HORSE PIKE STE 104
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-2257
Mailing Address - Country:US
Mailing Address - Phone:856-210-6191
Mailing Address - Fax:844-927-4815
Practice Address - Street 1:289 WHITE HORSE PIKE STE 104
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2257
Practice Address - Country:US
Practice Address - Phone:856-210-6191
Practice Address - Fax:844-927-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies