MEDICARE: D-MAN COMPANY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2006-195711-R	VA

General Provider Information

NPI Number	:	1114935558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D-MAN COMPANY INC.

Provider Business Mailing Address
First Line	:	585 S BIRDNECK RD
Second Line	:	SUITE 106
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-5898
Country	:	US
Telephone Number	:	757-437-2501
Fax Number	:	757-437-2503

Provider Business Practice Location Address
First Line	:	585 S BIRDNECK RD
Second Line	:	SUITE 106
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-5898
Country	:	US
Telephone Number	:	757-437-2501
Fax Number	:	757-437-2503

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DENNIS LYNN WILLIAMSON
Credential	:
Telephone Number	:	757-437-2501

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/26/2007

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