Organization
PACIFICO ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIA MASEY (COO)
(251) 388-9055
Entity
Organization
Contact information
Practice address
30 SCHILLINGER RD N STE 102, MOBILE, AL 36608-5060
(251) 388-9055
Mailing address
30 SCHILLINGER RD N STE 102, MOBILE, AL 36608-5060
(251) 388-9055
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
02/19/2025
Last updated
04/30/2025
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