Healthcare Provider Details

I. General information

NPI: 1518964956
Provider Name (Legal Business Name): MAROSA SURGICAL INDUSTRIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1277 S GOVERNORS AVE
DOVER DE
19904-4801
US

IV. Provider business mailing address

1277 S GOVERNORS AVE
DOVER DE
19904-4801
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-0907
  • Fax:
Mailing address:
  • Phone: 302-674-0907
  • Fax: 302-674-1421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ADAM BENNETT SAMUEL
Title or Position: PRESIDENT
Credential: CRTS, ATS
Phone: 302-674-0907