Provider Demographics
NPI:1003437609
Name:DAMASIUS INC
Entity Type:Organization
Organization Name:DAMASIUS INC
Other - Org Name:VYTO'S PHARMACY 1 LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:JONAS
Authorized Official - Last Name:DAMASIUS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:219-845-2900
Mailing Address - Street 1:6949 KENNEDY AVE STE C
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46323-2245
Mailing Address - Country:US
Mailing Address - Phone:219-845-2900
Mailing Address - Fax:219-844-1983
Practice Address - Street 1:6949 KENNEDY AVE STE C
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323-2245
Practice Address - Country:US
Practice Address - Phone:219-845-2900
Practice Address - Fax:219-844-1983
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAMASIUS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-05
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100201130AMedicaid