MEDICARE: HEALTH TECH AFFILIATES, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	MG00189	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144265299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH TECH AFFILIATES, INC.

Provider Business Mailing Address
First Line	:	350 N HUMPHREYS BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2177
Country	:	US
Telephone Number	:	870-633-5176
Fax Number	:	870-630-0530

Provider Business Practice Location Address
First Line	:	900 N WASHINGTON ST
Second Line	:
City	:	FORREST CITY
State	:	AR
Zip	:	72335-2856
Country	:	US
Telephone Number	:	870-633-5176
Fax Number	:	870-630-0530

Authorized Official
Title or Position	:	SR VP/ CLO
Name	:	MR. GREGORY M. DUCKETT
Credential	:
Telephone Number	:	901-227-4137

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	10/05/2020

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