Provider Demographics
NPI:1083168736
Name:DURALIFE, INC.
Entity Type:Organization
Organization Name:DURALIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-323-9743
Mailing Address - Street 1:195 PHILLIPS PARK DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SOUTH WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17702-7067
Mailing Address - Country:US
Mailing Address - Phone:570-323-9743
Mailing Address - Fax:
Practice Address - Street 1:195 PHILLIPS PARK DR
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17702-7067
Practice Address - Country:US
Practice Address - Phone:570-323-9743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA-23553332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment