Provider Demographics
NPI:1003826561
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:MRS
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:30093-2924
Mailing Address - Country:US
Mailing Address - Phone:770-449-6785
Mailing Address - Fax:
Practice Address - Street 1:2318 E PASS RD
Practice Address - Street 2:SUITE A
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3805
Practice Address - Country:US
Practice Address - Phone:800-449-6785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00428678FMedicaid
GA00428678FMedicaid