Healthcare Provider Details

I. General information

NPI: 1770135709
Provider Name (Legal Business Name): DABCI MARKET SHARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 E HIGHWAY 72
ROLLA MO
65401-4070
US

IV. Provider business mailing address

411 E HIGHWAY 72
ROLLA MO
65401-4070
US

V. Phone/Fax

Practice location:
  • Phone: 573-341-8240
  • Fax: 775-878-0020
Mailing address:
  • Phone: 573-341-8240
  • Fax: 775-878-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PINC NATIONWIDE SERVICES
Title or Position: OWNER
Credential: ND
Phone: 573-341-8240