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General NPI Number Information
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NPI Number | 1083168736
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Entity Type | Organization
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Legal Business Name | DURALIFE, INC.
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 195 PHILLIPS PARK DR SUITE 6
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City | SOUTH WILLIAMSPORT
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State | PA
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Zip | 17702-7067
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Country | US
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Telephone | 570-323-9743
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Fax |
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Provider Business Mailing Address
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Address Line | 195 PHILLIPS PARK DR SUITE 6
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City | SOUTH WILLIAMSPORT
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State | PA
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Zip | 17702-7067
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Country | US
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Telephone | 570-323-9743
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAN DAY
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Credential |
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Telephone | 570-323-9743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | PA-23553
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License Number State | PA
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