Provider Demographics
NPI:1316559545
Name:MRC HOSPITALITY GROUP
Entity Type:Organization
Organization Name:MRC HOSPITALITY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-394-1621
Mailing Address - Street 1:135 S SPRINGFIELD RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:CLIFTON HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:19018-2343
Mailing Address - Country:US
Mailing Address - Phone:267-394-1621
Mailing Address - Fax:
Practice Address - Street 1:99 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023
Practice Address - Country:US
Practice Address - Phone:267-394-1621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty