Provider Demographics
NPI:1093285843
Name:MRC HEALTH, LLC
Entity Type:Organization
Organization Name:MRC HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:GOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:972-442-5333
Mailing Address - Street 1:4008 KINGSWICK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-3215
Mailing Address - Country:US
Mailing Address - Phone:817-933-2411
Mailing Address - Fax:
Practice Address - Street 1:2300 W FM 544 STE 130
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4903
Practice Address - Country:US
Practice Address - Phone:972-442-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy