Provider Demographics
NPI:1841332897
Name:DAEDALUS HEALTH INFORMATION SYSTEMS, INC.
Entity type:Organization
Organization Name:DAEDALUS HEALTH INFORMATION SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCULLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPD
Authorized Official - Phone:703-360-5700
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:VA
Mailing Address - Zip Code:22121-0096
Mailing Address - Country:US
Mailing Address - Phone:703-360-5700
Mailing Address - Fax:703-360-1974
Practice Address - Street 1:8305 RICHMOND HWY
Practice Address - Street 2:SUITE 10A
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2348
Practice Address - Country:US
Practice Address - Phone:703-360-5700
Practice Address - Fax:703-360-1974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies