Organization
MADRAG LLC
Active
Other names
101 Mobility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEL BILL RAGLAND (OWNER)
(484) 437-4097
Entity
Organization
Contact information
Practice address
200 BETHLEHEM DR BLDG C-145, MORGANTOWN, PA 19543-9771
(610) 913-0060
(610) 913-0065
Mailing address
200 BETHLEHEM DR BLDG C-145, MORGANTOWN, PA 19543-9771
(610) 913-0060
(610) 913-0065
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
6000007663
PA
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033408400002
—
PA
Enumeration date
08/04/2017
Last updated
07/21/2022
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