MEDICARE: PROTECH MEDICAL LLC

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)
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000001001	OTHER	TN	HME LICENSE

General Provider Information

NPI Number	:	1881454098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROTECH MEDICAL LLC

Provider Business Mailing Address
First Line	:	1100 HATCHER LN
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-3530
Country	:	US
Telephone Number	:	800-722-7313
Fax Number	:	931-540-8209

Provider Business Practice Location Address
First Line	:	7405 SHALLOWFORD RD STE 190
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-2678
Country	:	US
Telephone Number	:	423-777-8601
Fax Number	:	423-719-6044

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DAVID BAXTER
Credential	:
Telephone Number	:	800-722-7313

Provider Enumeration Date	:	03/22/2024
Last Update Date	:	06/03/2026

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Directions to “PROTECH MEDICAL LLC ” Practice Location

Language	Start Address	Practice Location

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