Provider Demographics
NPI:1487057725
Name:MEDALLION HEALTH GROUP LLC
Entity type:Organization
Organization Name:MEDALLION HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:214-907-1283
Mailing Address - Street 1:2611 N BELT LINE RD
Mailing Address - Street 2:SUITE 162
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-9301
Mailing Address - Country:US
Mailing Address - Phone:214-907-1283
Mailing Address - Fax:
Practice Address - Street 1:2611 N BELT LINE RD
Practice Address - Street 2:SUITE 162
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9301
Practice Address - Country:US
Practice Address - Phone:214-907-1283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty