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General NPI Number Information
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NPI Number | 1205977428
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Entity Type | Organization
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Legal Business Name | MONTFORD MEDICAL SERVICES
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 218 TRELLIS WALK
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City | CENTERVILLE
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State | GA
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Zip | 31028-8510
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Country | US
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Telephone | 478-971-1299
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Fax | 478-953-6879
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Provider Business Mailing Address
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Address Line | PO BOX 2181
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City | WARNER ROBINS
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State | GA
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Zip | 31099-2181
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Country | US
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Telephone | 478-971-1299
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Fax | 478-953-6879
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Authorized Official
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Title or Position | OWNER
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Name | MR. EDWARD LEVESTER MONTFORD SR.
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Credential |
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Telephone | 478-971-1299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | GA
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