MEDICARE: HEALTH TECH INNOVATIONS

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	3336H0001X	Home Infusion Therapy Pharmacy	PHRE008040	GA

General Provider Information

NPI Number	:	1932326402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH TECH INNOVATIONS

Provider Business Mailing Address
First Line	:	212 NORTHSIDE DR
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-1858
Country	:	US
Telephone Number	:	229-242-3060
Fax Number	:	229-242-9914

Provider Business Practice Location Address
First Line	:	212 NORTHSIDE DR
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-1858
Country	:	US
Telephone Number	:	229-242-3060
Fax Number	:	229-242-9914

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFF SIKES
Credential	:
Telephone Number	:	229-242-3060

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	08/22/2020

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