Healthcare Provider Details

I. General information

NPI: 1295738912
Provider Name (Legal Business Name): MEDTECH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N HARPER RD
CORINTH MS
38834-5271
US

IV. Provider business mailing address

207 N HARPER RD
CORINTH MS
38834-5271
US

V. Phone/Fax

Practice location:
  • Phone: 662-665-9800
  • Fax:
Mailing address:
  • Phone: 662-665-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number05685/11.1
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number05774/02.0
License Number StateMS

VIII. Authorized Official

Name: MR. DONALD O. KING III
Title or Position: OWNER
Credential:
Phone: 662-665-9800