Provider Demographics
NPI:1790831113
Name:MEDTECH ENTERPRISES
Entity Type:Organization
Organization Name:MEDTECH ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LENNIE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:FURR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-304-2879
Mailing Address - Street 1:5251 HIGHWAY 153 STE C
Mailing Address - Street 2:193
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6925 SHALLOWFORD RD
Practice Address - Street 2:207
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1787
Practice Address - Country:US
Practice Address - Phone:423-304-2879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies