Moore, Derrick Monterey
Moore, Derrick Monterey is an sole proprietor health care provider with primary practice located at 8325 Poplar Springs Dr Lot 55 , Meridian MS 39305-9243. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Moore, Derrick Monterey can be contacted via phone (601) 681-4582.Contact Information
Primary practice address
8325 Poplar Springs Dr Lot 55
Meridian MS 39305-9243
Phone: (601) 681-4582
Fax: (601) 681-9642
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | 9205865 | Mississippi |
Profile Details
| NPI number | 1770739872 |
|---|---|
| LBN Legal business name | Moore, Derrick Monterey |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 8th, 2008 |
| Last updated | Aug 8th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770739872 | NPPES |
| Mississippi | MEDICAID | 02926254 |
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