Provider Demographics
NPI:1326202680
Name:DAL MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:DAL MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:SOLOMAN
Authorized Official - Last Name:LICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-327-1001
Mailing Address - Street 1:12300 FORD RD
Mailing Address - Street 2:SUITE 455
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7248
Mailing Address - Country:US
Mailing Address - Phone:214-597-5154
Mailing Address - Fax:866-593-7723
Practice Address - Street 1:12300 FORD RD
Practice Address - Street 2:SUITE 455
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7248
Practice Address - Country:US
Practice Address - Phone:214-597-5154
Practice Address - Fax:866-593-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies