Mondragon, Jorge
Mondragon, Jorge is an sole proprietor health care provider with primary practice located at 311 Plum Run Rd , Mannington WV 26582-7279. He recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as his primary health care specialty. Mondragon, Jorge can be contacted via phone (304) 694-6423.Contact Information
Primary practice address
311 Plum Run Rd
Mannington WV 26582-7279
Phone: (304) 694-6423
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X |
Profile Details
| NPI number | 1053913137 |
|---|---|
| LBN Legal business name | Mondragon, Jorge |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 12th, 2020 |
| Last updated | Nov 12th, 2020 - about 4 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 | 1053913137 | NPPES |
| West Virginia | MEDICAID | 3046946423 |
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