Provider Demographics
NPI:1932332764
Name:MEDTECH
Entity Type:Organization
Organization Name:MEDTECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:MACRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-641-7276
Mailing Address - Street 1:284 RACEBROOK RD
Mailing Address - Street 2:SUITE # 217
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3103
Mailing Address - Country:US
Mailing Address - Phone:203-298-0677
Mailing Address - Fax:
Practice Address - Street 1:284 RACEBROOK RD
Practice Address - Street 2:SUITE # 217
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3103
Practice Address - Country:US
Practice Address - Phone:203-298-0677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies