Provider Demographics
NPI:1649473885
Name:PRO TECH DISTRIBUTORS INC
Entity type:Organization
Organization Name:PRO TECH DISTRIBUTORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-923-2349
Mailing Address - Street 1:17104 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:IL
Mailing Address - Zip Code:60152-8268
Mailing Address - Country:US
Mailing Address - Phone:815-923-2349
Mailing Address - Fax:815-923-4021
Practice Address - Street 1:17104 FIELDSTONE DR
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:IL
Practice Address - Zip Code:60152-8268
Practice Address - Country:US
Practice Address - Phone:815-923-2349
Practice Address - Fax:815-923-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier