Provider Demographics
NPI:1396128484
Name:DASCO HME, LLC
Entity type:Organization
Organization Name:DASCO HME, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MAZUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-901-2226
Mailing Address - Street 1:375 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-1400
Mailing Address - Country:US
Mailing Address - Phone:614-901-2226
Mailing Address - Fax:614-901-2868
Practice Address - Street 1:653 MCCORKLE BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7158
Practice Address - Country:US
Practice Address - Phone:614-392-4339
Practice Address - Fax:614-901-2868
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DASCO INVESTMENT HOLDCO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-07
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0159627Medicaid