Provider Demographics
NPI:1235570789
Name:MRI GROUP, LLP
Entity Type:Organization
Organization Name:MRI GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:LUANN
Authorized Official - Middle Name:V
Authorized Official - Last Name:PAULIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-412-1295
Mailing Address - Street 1:PO BOX 4216
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-4216
Mailing Address - Country:US
Mailing Address - Phone:717-394-6028
Mailing Address - Fax:717-509-6362
Practice Address - Street 1:950 S OCTORARA TRL
Practice Address - Street 2:
Practice Address - City:PARKESBURG
Practice Address - State:PA
Practice Address - Zip Code:19365-2100
Practice Address - Country:US
Practice Address - Phone:717-291-1016
Practice Address - Fax:717-291-4683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019211580013Medicaid