MEDICARE: INDUSTRIAL TOOL & DIE, 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

General Provider Information

NPI Number	:	1174609002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDUSTRIAL TOOL & DIE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 128
Second Line	:
City	:	MORRISON
State	:	TN
Zip	:	37357-0128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	886 MT VIEW INDUSTRIAL DR
Second Line	:
City	:	MORRISON
State	:	TN
Zip	:	37357-5916
Country	:	US
Telephone Number	:	931-668-7157
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL PRATER
Credential	:
Telephone Number	:	931-668-7157

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	08/22/2020

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