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General NPI Number Information
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NPI Number | 1114766516
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Entity Type | Organization
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Legal Business Name | MOUNTAINTOP TECHNOLOGY, INC.
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 610 S FAIRMONT AVE
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City | LODI
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State | CA
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Zip | 95240-3835
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Country | US
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Telephone | 732-322-9919
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Fax |
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Provider Business Mailing Address
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Address Line | 10050 RICHARD IBARRA WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-6439
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Country | US
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Telephone | 732-322-9919
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. REGINALD GORING
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Credential | MBA, NHA
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Telephone | 732-322-9919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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