Provider Demographics
NPI:1740428044
Name:CARDI'S DEPARTMENT STORE INC
Entity Type:Organization
Organization Name:CARDI'S DEPARTMENT STORE INC
Other - Org Name:CARDI'S FURNITURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:P
Authorized Official - Last Name:CARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-379-7510
Mailing Address - Street 1:1 FURNITURE WAY
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3424
Mailing Address - Country:US
Mailing Address - Phone:508-379-7510
Mailing Address - Fax:508-379-3667
Practice Address - Street 1:1 FURNITURE WAY
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3424
Practice Address - Country:US
Practice Address - Phone:508-379-7510
Practice Address - Fax:508-379-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5409659332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6328080001Medicare NSC