Provider Demographics
NPI:1528169661
Name:MCGREEVY INC
Entity type:Organization
Organization Name:MCGREEVY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCGREEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-827-3857
Mailing Address - Street 1:115 EAST LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408
Mailing Address - Country:US
Mailing Address - Phone:612-827-3857
Mailing Address - Fax:612-827-7204
Practice Address - Street 1:115 EAST LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408
Practice Address - Country:US
Practice Address - Phone:612-827-3857
Practice Address - Fax:612-827-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN102433OtherUCARE
MN21161991OtherMEDICA
MN92237OtherPREFERRED ONE
MN09301PEOtherBLUE CROSS BLUE SHIELD
MN13390PEOtherBLUE CROSS BLUE SHIELD
MN13390PEOtherBLUE CROSS BLUE SHIELD