Healthcare Provider Details

I. General information

NPI: 1225505589
Provider Name (Legal Business Name): OADC DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 SOUTH RD
POUGHKEEPSIE NY
12601-6027
US

IV. Provider business mailing address

1910 SOUTH RD
POUGHKEEPSIE NY
12601-6027
US

V. Phone/Fax

Practice location:
  • Phone: 845-454-0120
  • Fax: 845-686-9016
Mailing address:
  • Phone: 845-454-0120
  • Fax: 845-686-9016

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: MARIBETH CHACH
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 845-454-0120