Healthcare Provider Details

I. General information

NPI: 1669462263
Provider Name (Legal Business Name): DW VOGHT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 06/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CHURCH ST
CANAJOHARIE NY
13317-1165
US

IV. Provider business mailing address

26 CHURCH ST
CANAJOHARIE NY
13317-1165
US

V. Phone/Fax

Practice location:
  • Phone: 518-673-8086
  • Fax: 518-673-5112
Mailing address:
  • Phone: 518-673-8086
  • Fax: 518-673-5112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number024246
License Number StateNY

VIII. Authorized Official

Name: DAVID VOGHT
Title or Position: PRES
Credential:
Phone: 518-673-8086