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General NPI Number Information
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NPI Number | 1396961421
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Entity Type | Organization
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Legal Business Name | DBO HOLDINGS, LLC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14520 W MAYLORE CT
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City | NEW BERLIN
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State | WI
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Zip | 53151-1215
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Country | US
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Telephone | 414-704-7810
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Fax |
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Provider Business Mailing Address
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Address Line | 14520 W MAYLORE CT
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City | NEW BERLIN
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State | WI
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Zip | 53151-1215
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Country | US
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Telephone | 414-704-7810
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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. DMITRI B OLEXENKO
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Credential |
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Telephone | 414-704-7810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | D040550
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License Number State | WI
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