Healthcare Provider Details

I. General information

NPI: 1487302469
Provider Name (Legal Business Name): HUMAN TECHNOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6029 WALNUT GROVE ROAD MEDICAL PLAZA 3, STE 109
MEMPHIS TN
38120-2112
US

IV. Provider business mailing address

266 S. CLEVELAND STREET SUITE 102
MEMPHIS TN
38104-3520
US

V. Phone/Fax

Practice location:
  • Phone: 901-455-0228
  • Fax: 901-531-8142
Mailing address:
  • Phone: 901-590-0354
  • Fax: 901-590-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: RAMESH DUBEY
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 901-359-2133