Provider Demographics
NPI:1881454098
Name:PROTECH MEDICAL LLC
Entity type:Organization
Organization Name:PROTECH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-722-7313
Mailing Address - Street 1:1100 HATCHER LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3530
Mailing Address - Country:US
Mailing Address - Phone:800-722-7313
Mailing Address - Fax:931-540-8209
Practice Address - Street 1:7405 SHALLOWFORD RD STE 190
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2678
Practice Address - Country:US
Practice Address - Phone:423-777-8601
Practice Address - Fax:423-719-6044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000001001OtherHME LICENSE