Healthcare Provider Details

I. General information

NPI: 1598183501
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

139 W MAIN ST
ELKTON MD
21921-5540
US

IV. Provider business mailing address

PO BOX 1040
ELKTON MD
21922-1040
US

V. Phone/Fax

Practice location:
  • Phone: 443-245-7210
  • Fax:
Mailing address:
  • Phone: 410-398-0590
  • Fax: 443-245-3737

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: ZAHID ASLAM
Title or Position: MANAGING MEMEBER
Credential: M.D.
Phone: 443-245-7210