Provider Demographics
NPI:1861415572
Name:MARLAB,INC
Entity type:Organization
Organization Name:MARLAB,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LADD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-544-1336
Mailing Address - Street 1:105 W NC HIGHWAY 54
Mailing Address - Street 2:SUITE 267
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6646
Mailing Address - Country:US
Mailing Address - Phone:919-544-1336
Mailing Address - Fax:919-806-3397
Practice Address - Street 1:24 GORDON ST
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573
Practice Address - Country:US
Practice Address - Phone:336-599-7930
Practice Address - Fax:336-599-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0885390002Medicare NSC