MEDICARE: MTG FINANCIAL SERVICES AND ASSOC.

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		TN

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	:	1851327183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MTG FINANCIAL SERVICES AND ASSOC.

Provider Business Mailing Address
First Line	:	3340 POPLAR AVE STE 221
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-4680
Country	:	US
Telephone Number	:	901-647-3482
Fax Number	:	662-890-1189

Provider Business Practice Location Address
First Line	:	3340 POPLAR AVE STE 221
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-4680
Country	:	US
Telephone Number	:	901-647-3482
Fax Number	:	662-890-1189

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MARTEESE THARA GOLDEN
Credential	:
Telephone Number	:	901-647-3482

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/21/2022

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