Provider Demographics
NPI:1245417146
Name:MED TECH, LLC
Entity Type:Organization
Organization Name:MED TECH, LLC
Other - Org Name:MED TECH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAYDEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-348-3048
Mailing Address - Street 1:1310 S TRYON ST
Mailing Address - Street 2:STE 103
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4232
Mailing Address - Country:US
Mailing Address - Phone:704-348-3048
Mailing Address - Fax:704-348-3049
Practice Address - Street 1:1310 S TRYON ST
Practice Address - Street 2:STE 103
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4232
Practice Address - Country:US
Practice Address - Phone:704-348-3048
Practice Address - Fax:704-348-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01374332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies