Healthcare Provider Details

I. General information

NPI: 1184042111
Provider Name (Legal Business Name): MEDTIX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 W STATE COLLEGE RD SUITE 100
DOVER DE
19904-6513
US

IV. Provider business mailing address

16337 COASTAL HWY
LEWES DE
19958-3607
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-8070
  • Fax: 302-645-8870
Mailing address:
  • Phone: 302-645-8070
  • Fax: 302-645-8870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: TAMMIE DRAINE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 302-645-8070