Healthcare Provider Details

I. General information

NPI: 1194759639
Provider Name (Legal Business Name): DAYVAULT'S HOME MEDICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 06/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1254 26TH ST SE BLDG 9
HICKORY NC
28602-7317
US

IV. Provider business mailing address

350 PINE ST SUITE 330
BEAUMONT TX
77701-2437
US

V. Phone/Fax

Practice location:
  • Phone: 828-754-1655
  • Fax: 203-702-6840
Mailing address:
  • Phone: 409-832-7013
  • Fax: 203-702-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: SCOTT KALTRIDER
Title or Position: PRESIDENT
Credential:
Phone: 203-837-2330