Organization
MATTHEW W CRAIN
Active
Other names
BIO-TEK MEDICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW W CRAIN COF (OWNER)
(662) 890-6862
Entity
Organization
Contact information
Practice address
3845 GOODMAN RD E, SOUTHAVEN, MS 38672-6444
(662) 890-6862
(662) 890-6865
Mailing address
3845 GOODMAN RD E, SOUTHAVEN, MS 38672-6444
(662) 890-6862
(662) 890-6865
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00303087
—
MS
01
—
1082062
USA MANAGED CARE NETWORK
MS
05
—
1455144
—
TN
05
—
163731716
—
AR
01
—
4146633
BCBS TN
TN
01
—
612772600
OWCP
MS
Enumeration date
01/03/2007
Last updated
04/14/2011
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