Provider Demographics
NPI:1497909725
Name:M.A. DIGIULIO LLC
Entity Type:Organization
Organization Name:M.A. DIGIULIO LLC
Other - Org Name:DIGIULIOS SHOES
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIGIULIO
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:856-488-9100
Mailing Address - Street 1:826 HADDONFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002
Mailing Address - Country:US
Mailing Address - Phone:856-488-9100
Mailing Address - Fax:856-488-9110
Practice Address - Street 1:826 HADDONFIELD ROAD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002
Practice Address - Country:US
Practice Address - Phone:856-488-9100
Practice Address - Fax:856-488-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCPED 0571332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies