Provider Demographics
NPI:1467576470
Name:HI-TECH HEALTHCARE INC
Entity Type:Organization
Organization Name:HI-TECH HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:BS,RRT
Authorized Official - Phone:770-449-6785
Mailing Address - Street 1:1805 SHACKLEFORD CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-7000
Mailing Address - Country:US
Mailing Address - Phone:770-449-6785
Mailing Address - Fax:770-449-0648
Practice Address - Street 1:502 S ENOTA DR NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2546
Practice Address - Country:US
Practice Address - Phone:770-536-7670
Practice Address - Fax:770-536-7640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00428678EMedicaid
GA00428678EMedicaid