Provider Demographics
NPI:1720651441
Name:MRC PRODUCTS INC
Entity Type:Organization
Organization Name:MRC PRODUCTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-339-7165
Mailing Address - Street 1:5288 SANDY LK E
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-3958
Mailing Address - Country:US
Mailing Address - Phone:404-218-2508
Mailing Address - Fax:
Practice Address - Street 1:5288 SANDY LK E
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-3958
Practice Address - Country:US
Practice Address - Phone:404-218-2508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech