MEDICARE: HI-TECH HEALTHCARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)
2	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003826561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HI-TECH HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	1805 SHACKLEFORD CT
Second Line	:	SUITE 100
City	:	NORCROSS
State	:	GA
Zip	:	30093-2924
Country	:	US
Telephone Number	:	770-449-6785
Fax Number	:

Provider Business Practice Location Address
First Line	:	2318 E PASS RD
Second Line	:	SUITE A
City	:	GULFPORT
State	:	MS
Zip	:	39507-3805
Country	:	US
Telephone Number	:	800-449-6785
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. GARY TODD TYSON
Credential	:	BS,RRT
Telephone Number	:	770-449-6785

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	06/18/2008

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