Provider Demographics
NPI:1730637497
Name:DAIS MEDICAL SUPPLY STORE
Entity Type:Organization
Organization Name:DAIS MEDICAL SUPPLY STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:DEMATTEIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-709-4865
Mailing Address - Street 1:536 MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:AMBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15003-2463
Mailing Address - Country:US
Mailing Address - Phone:724-709-4865
Mailing Address - Fax:
Practice Address - Street 1:536 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-2463
Practice Address - Country:US
Practice Address - Phone:724-709-4865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies