Provider Demographics
NPI:1891503017
Name:HAGAN INDUSTRIES LLC
Entity type:Organization
Organization Name:HAGAN INDUSTRIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-279-2824
Mailing Address - Street 1:6317 TEAL LANE
Mailing Address - Street 2:
Mailing Address - City:CHINCOTEAGUE ISLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23336
Mailing Address - Country:US
Mailing Address - Phone:410-279-2824
Mailing Address - Fax:
Practice Address - Street 1:6317 TEAL LANE
Practice Address - Street 2:
Practice Address - City:CHINCOTEAGUE ISLAND
Practice Address - State:VA
Practice Address - Zip Code:23336
Practice Address - Country:US
Practice Address - Phone:410-279-2824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health