Provider Demographics
NPI:1073852331
Name:MRNB INC
Entity Type:Organization
Organization Name:MRNB INC
Other - Org Name:ROSS DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-654-0081
Mailing Address - Street 1:340 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-1508
Mailing Address - Country:US
Mailing Address - Phone:304-397-5071
Mailing Address - Fax:304-397-5072
Practice Address - Street 1:340 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WV
Practice Address - Zip Code:25541-1508
Practice Address - Country:US
Practice Address - Phone:304-397-5071
Practice Address - Fax:304-397-5072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSP0552445333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy