Provider Demographics
NPI:1982873428
Name:DRS. MONTMINY, INC.
Entity Type:Organization
Organization Name:DRS. MONTMINY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MONTMINY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-459-0702
Mailing Address - Street 1:75 ARCAND DR
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1026
Mailing Address - Country:US
Mailing Address - Phone:978-459-0702
Mailing Address - Fax:
Practice Address - Street 1:75 ARCAND DR
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1026
Practice Address - Country:US
Practice Address - Phone:978-459-0702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2264302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization