Provider Demographics
NPI:1821047937
Name:DAISY MEDICAL SUPPLY
Entity Type:Organization
Organization Name:DAISY MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-944-4759
Mailing Address - Street 1:624 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-5318
Mailing Address - Country:US
Mailing Address - Phone:812-944-4757
Mailing Address - Fax:812-948-8277
Practice Address - Street 1:624 CHERRY ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-5318
Practice Address - Country:US
Practice Address - Phone:812-944-4757
Practice Address - Fax:812-948-8277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherFEDERAL I.D. NUMBER
IN0390200001Medicare ID - Type Unspecified