Provider Demographics
NPI:1033135629
Name:MEDICAL RESOURCE MANAGEMENT
Entity Type:Organization
Organization Name:MEDICAL RESOURCE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:O
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:CHIEF FINANCIAL OFFI
Authorized Official - Phone:336-621-8911
Mailing Address - Street 1:2703 HENRY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-3669
Mailing Address - Country:US
Mailing Address - Phone:336-375-8424
Mailing Address - Fax:336-375-8848
Practice Address - Street 1:2703 HENRY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-3669
Practice Address - Country:US
Practice Address - Phone:336-375-8424
Practice Address - Fax:336-375-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2341121Medicare ID - Type Unspecified