Provider Demographics
NPI:1164691853
Name:DALCO ENTERPRISES INC
Entity Type:Organization
Organization Name:DALCO ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-388-0522
Mailing Address - Street 1:3602 CYPRESS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7314
Mailing Address - Country:US
Mailing Address - Phone:318-388-0522
Mailing Address - Fax:
Practice Address - Street 1:1825 N FRONTAGE RD
Practice Address - Street 2:SUITE D
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-5178
Practice Address - Country:US
Practice Address - Phone:318-388-0522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5896710001332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment