Provider Demographics
NPI:1467918185
Name:DOMINION SEVEN, LLC
Entity Type:Organization
Organization Name:DOMINION SEVEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERMAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANDOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-732-5592
Mailing Address - Street 1:392 E TREMONT AVE STE 45
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4241
Mailing Address - Country:US
Mailing Address - Phone:646-732-5592
Mailing Address - Fax:
Practice Address - Street 1:392 E TREMONT AVE STE 45
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4241
Practice Address - Country:US
Practice Address - Phone:646-732-5592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies