Doctor Name: | MONTAGO MAURICE WRIGHT |
NPI Number: | 1962869180 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 511 Palmetto Dr Simpsonville, SC - 296816128 |
Business Phone Number: | 8645090435 |
Business Fax Number: | 8645090250 |
Mailing Address: | 201b W Butler Rd, MAULDIN |
State: | SC |
Postal Code: | 296622536 |
Phone Number: | 8645090435 |
Fax Number: | 8645090250 |
NPI Enumeration Date: | 01/19/2016 |
NPI Last Update Date: | 01/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |