Provider Demographics
NPI:1801934898
Name:DAMASIUS INC
Entity type:Organization
Organization Name:DAMASIUS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMASIUS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:219-972-1700
Mailing Address - Street 1:8845 KENNEDY AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1908
Mailing Address - Country:US
Mailing Address - Phone:219-972-1700
Mailing Address - Fax:219-972-1915
Practice Address - Street 1:8845 KENNEDY AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1908
Practice Address - Country:US
Practice Address - Phone:219-972-1700
Practice Address - Fax:219-972-1915
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAMASIUS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-02
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
IN60006040A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100201130BMedicaid
2025491OtherPK