MEDICARE: MEDTECH OF CORINTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	05685/11.1	MS

General Provider Information

NPI Number	:	1073743662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDTECH OF CORINTH

Provider Business Mailing Address
First Line	:	207 N HARPER RD
Second Line	:
City	:	CORINTH
State	:	MS
Zip	:	38834-5271
Country	:	US
Telephone Number	:	662-665-9800
Fax Number	:	662-665-9834

Provider Business Practice Location Address
First Line	:	207 N HARPER RD
Second Line	:
City	:	CORINTH
State	:	MS
Zip	:	38834-5271
Country	:	US
Telephone Number	:	662-665-9800
Fax Number	:	662-665-9834

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MRS. DUSTY D KYLE
Credential	:
Telephone Number	:	662-665-9800

Provider Enumeration Date	:	07/17/2009
Last Update Date	:	07/17/2009

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Directions to “MEDTECH OF CORINTH ” Practice Location

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