1710323415 NPI number — TECH MEDICAL INC

Table of content: (NPI 1710323415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710323415 NPI number — TECH MEDICAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TECH MEDICAL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710323415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1014 BELLEFONTE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLATWOODS
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41139-1904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-393-6606
Provider Business Mailing Address Fax Number:
606-644-0816

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 VERNON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHEELERSBURG
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45694-8511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-414-8090
Provider Business Practice Location Address Fax Number:
740-879-0792
Provider Enumeration Date:
05/21/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PARKER
Authorized Official First Name:
WANDA
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
606-232-6750

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X , with the licence number: 150197 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)