Provider Demographics
NPI:1902312093
Name:THE WRIGHT CENTER MEDICAL GROUP
Entity Type:Organization
Organization Name:THE WRIGHT CENTER MEDICAL GROUP
Other - Org Name:THE WRIGHT CENTER MEDICAL GROUP/ DIABETES PREVENTION
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-343-2383
Mailing Address - Street 1:111 N WASHINGTON AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1841
Mailing Address - Country:US
Mailing Address - Phone:570-591-5159
Mailing Address - Fax:570-343-3923
Practice Address - Street 1:5 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JERMYN
Practice Address - State:PA
Practice Address - Zip Code:18433-1121
Practice Address - Country:US
Practice Address - Phone:570-383-9934
Practice Address - Fax:570-230-0023
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE WRIGHT CENTER MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-27
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty