Provider Demographics
NPI:1821322017
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:EXEC DIRECTOR OF ADMIN AND FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALVARSON
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:
Practice Address - Street 1:999 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-7035
Practice Address - Country:US
Practice Address - Phone:508-915-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6328080003Medicare NSC