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General NPI Number Information
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NPI Number | 1790757086
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Entity Type | Organization
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Legal Business Name | MEDICAL TECHNOLOGY RESOURCES LLC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1010 E TAYLOR STATION ROAD
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City | GAHANNA
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State | OH
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Zip | 43230
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Country | US
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Telephone | 614-866-9516
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Fax | 614-866-9520
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Provider Business Mailing Address
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Address Line | 1010 E TAYLOR STATION ROAD
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City | GAHANNA
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State | OH
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Zip | 43230
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Country | US
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Telephone | 614-866-9516
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Fax | 614-866-9520
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. ANDREW ROBERT AMICON
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Credential |
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Telephone | 614-866-9516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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