Healthcare Provider Details

I. General information

NPI: 1568219376
Provider Name (Legal Business Name): MRC INDUSTRIES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2538 S 26TH ST
KALAMAZOO MI
49048-9610
US

IV. Provider business mailing address

2538 S 26TH ST
KALAMAZOO MI
49048-9610
US

V. Phone/Fax

Practice location:
  • Phone: 269-343-0747
  • Fax: 269-343-2007
Mailing address:
  • Phone: 269-343-0747
  • Fax: 269-343-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARGARET I MILLER
Title or Position: COMPLIANCE SPECIALIST
Credential:
Phone: 269-343-0747