Provider Demographics
NPI:1699806810
Name:DANIEL HARGROVE
Entity Type:Organization
Organization Name:DANIEL HARGROVE
Other - Org Name:DBS O2 & MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-769-9775
Mailing Address - Street 1:798 ROUTE 45
Mailing Address - Street 2:
Mailing Address - City:PILESGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-2803
Mailing Address - Country:US
Mailing Address - Phone:856-769-5449
Mailing Address - Fax:856-769-8930
Practice Address - Street 1:1198 ROUTE 40
Practice Address - Street 2:
Practice Address - City:PILESGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08098-3106
Practice Address - Country:US
Practice Address - Phone:856-769-5449
Practice Address - Fax:856-769-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0117439Medicaid
NJ0117439Medicaid