Provider Demographics
NPI:1083898811
Name:MCG SOLUTIONS LLC
Entity Type:Organization
Organization Name:MCG SOLUTIONS LLC
Other - Org Name:GENESIS HEALTH MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMSON
Authorized Official - Middle Name:S
Authorized Official - Last Name:ARAWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-552-0277
Mailing Address - Street 1:2341 S COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-1224
Mailing Address - Country:US
Mailing Address - Phone:817-303-0011
Mailing Address - Fax:817-303-0012
Practice Address - Street 1:2341 S COLLINS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-1224
Practice Address - Country:US
Practice Address - Phone:817-303-0011
Practice Address - Fax:817-303-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0099966332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6091340001Medicare NSC