Provider Demographics
NPI:1598060329
Name:WRIGHT MEDICAL , LLC
Entity Type:Organization
Organization Name:WRIGHT MEDICAL , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-828-9139
Mailing Address - Street 1:2704 SUNNY ACRES DR N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-2341
Mailing Address - Country:US
Mailing Address - Phone:904-828-9139
Mailing Address - Fax:888-504-4043
Practice Address - Street 1:2704 SUNNY ACRES DR N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-2341
Practice Address - Country:US
Practice Address - Phone:904-828-9139
Practice Address - Fax:888-504-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies