Provider Demographics
NPI:1457551046
Name:NORCROSS MC INC
Entity Type:Organization
Organization Name:NORCROSS MC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:RIOS BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-551-7226
Mailing Address - Street 1:5555 BUFORD HWY
Mailing Address - Street 2:#509
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-3957
Mailing Address - Country:US
Mailing Address - Phone:404-551-7226
Mailing Address - Fax:
Practice Address - Street 1:5555 BUFORD HWY
Practice Address - Street 2:#509
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-3957
Practice Address - Country:US
Practice Address - Phone:404-551-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty