Provider Demographics
NPI:1275556615
Name:DOLLARISLAND INC
Entity Type:Organization
Organization Name:DOLLARISLAND INC
Other - Org Name:ADA SHOES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGOSHIDZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-210-0479
Mailing Address - Street 1:7590 HAVERFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2113
Mailing Address - Country:US
Mailing Address - Phone:215-877-1707
Mailing Address - Fax:215-877-1707
Practice Address - Street 1:7590 HAVERFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19151-2113
Practice Address - Country:US
Practice Address - Phone:215-877-1707
Practice Address - Fax:215-877-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies