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General NPI Number Information
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NPI Number | 1902075484
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Entity Type | Organization
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Legal Business Name | DALCO ENTERPRISES INC
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 2918 LOUIS SESSIONS
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City | LAKE VILLAGE
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State | AR
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Zip | 71653
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Country | US
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Telephone | 318-388-0522
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Fax |
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Provider Business Mailing Address
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Address Line | 3602 CYPRESS ST SUITE A
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City | WEST MONROE
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State | LA
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Zip | 71291
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Country | US
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Telephone | 318-388-0522
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LINDA C BUNCH
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Credential | MD
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Telephone | 318-388-0522
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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 | 5896710001
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License Number State | LA
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