Provider Demographics
NPI:1013465384
Name:THE MONTRYAN CORPORATION
Entity Type:Organization
Organization Name:THE MONTRYAN CORPORATION
Other - Org Name:MEDICAL CASE MANAGEMENT GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-893-0093
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-0938
Mailing Address - Country:US
Mailing Address - Phone:207-893-0093
Mailing Address - Fax:207-892-1531
Practice Address - Street 1:16 RURAL HL
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-5085
Practice Address - Country:US
Practice Address - Phone:207-893-0093
Practice Address - Fax:207-892-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management