Provider Demographics
NPI:1386024032
Name:MEDTECH SUPPORT, LLC
Entity type:Organization
Organization Name:MEDTECH SUPPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:PANNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-366-7301
Mailing Address - Street 1:3450 BABCOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237
Mailing Address - Country:US
Mailing Address - Phone:412-366-7301
Mailing Address - Fax:412-630-8253
Practice Address - Street 1:3450 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-366-7301
Practice Address - Fax:412-630-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty