1518129196 NPI number — MRI GROUP, LLP

Table of content: (NPI 1518129196)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518129196 NPI number — MRI GROUP, LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MRI GROUP, LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518129196
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4216
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17604-4216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-394-6028
Provider Business Mailing Address Fax Number:
717-509-6362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
560 N LIME ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602-2216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-291-1016
Provider Business Practice Location Address Fax Number:
717-509-8642
Provider Enumeration Date:
06/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PAULIN
Authorized Official First Name:
LUANN
Authorized Official Middle Name:
V
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
717-412-1295

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0019211580007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019211580009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019211580008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019211580001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019211580010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019211580012 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019211580011 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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