Provider Demographics
NPI:1851327183
Name:MTG FINANCIAL SERVICES AND ASSOC.
Entity Type:Organization
Organization Name:MTG FINANCIAL SERVICES AND ASSOC.
Other - Org Name:GOLDEN MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTEESE
Authorized Official - Middle Name:THARA
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-647-3482
Mailing Address - Street 1:3340 POPLAR AVE STE 221
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-4680
Mailing Address - Country:US
Mailing Address - Phone:901-647-3482
Mailing Address - Fax:662-890-1189
Practice Address - Street 1:3340 POPLAR AVE STE 221
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4680
Practice Address - Country:US
Practice Address - Phone:901-647-3482
Practice Address - Fax:662-890-1189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1455036Medicaid
TN1455036Medicaid